Case of microarteriovenous malformation-induced trigeminal neuralgia treated with radiosurgery

Abstract

Radiosurgery to the right fifth cranial nerve was performed with the Gamma Knife on a 39- year-old patient who presented with classic symptoms of trigeminal neuralgia (TN), but was found on imaging studies to harbour a small intrinsic vascular malformation within the nerve. Based on size and drainage, the arteriovenous malformation (AVM) was Spetzler-Martin Grade III and no previous history of bleeding was reported. The patient had failed a trial of carbamazepine, and no surgical procedures had been performed. A decrease in symptoms was reported by the 6-month follow- up. A review of the literature on microAVM-induced TN is provided as well as a discussion of management.

Trigeminal neuralgia due to arterialization of the superior petrosal vein in the context of dural or cerebral arteriovenous shunt

“…The Spetzler-Martin grade 17 was 3 in 4 cases and 4 in 1 case. All the AVMs presented multiple arterial supplies (2)(3)(4)(5), at least one of the superior cerebral arteries (SCA) was involved in every case and antero-inferior cerebellar arteries (AICA) were involved in 4 cases as well as the postero-inferior cerebellar arteries (PICA). Flowrelated arterial aneurysm was noted in 3 cases but without relation to the pons or the trigeminal nerve pathway.…”

“…2 The association between trigeminal neuralgia and arteriovenous shunt of cerebrum or dura has been reported in few cases only. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] Isolated cases reported good pain reversibility after embolization, 4,7,8,10,13, 15 surgery 2, 5, 6 or radiotherapy. 3,11,16 We report our cases of symptomatic trigeminal neuralgia secondary to brain arteriovenous malformation (bAVM) or dural arteriovenous fistula (DAVF) in order to understand the pathophysiology, the structure that compresses the nerve (in case of compression) and factors influencing the presence of the neuralgia.…”

Классическая Невралгия Тройничного Нерва

“…К та-ким заболеваниям относятся: опухоли мосто-мозжескового угла [67,145,181,211,244,248,287,319,347,348], арахноидиты задней че-репной ямки [142,323], аневризмы и артерио-венозные мальфор-мации вертебробазилярного бассейна [150,240,254,265,309,361,352,425], аномалии Арнольда-Киари [218,405], платибазии [264,357]. Клинически этот вид НТН отличается от классической нарастающим сенсорным дефицитом, не характерным для клас-сической НТН.…”

A Case of High-grade Arteriovenous Malformation Manifesting as Trigeminal Neuralgia Successfully Treated by Embolization in Multimodal Treatment

“…Symptomatic treatment with drugs, such as carbamazepine, and stereotactic radiosurgery (SRS) with gamma knife are performed, and microvascular decompression (MVD) is performed as radical treatment. 1) Cerebral arteriovenous malformation (AVM) rarely causes TGN, and many cases treated with direct surgery 2-7) and SRS 8,9) have been reported, but cases treated with embolization 4, [9][10][11][12][13] have also been occasionally reported. We encountered a rare case of high-grade AVM which manifested as TGN.…”