Trigeminal Neuralgia Caused by Venous Angioma

Yamamoto, Takuji; Suzuki, Mario; Esaki, Takanori; Nakao, Yasuaki; Mori, Kentaro

doi:10.2176/nmc.53.40

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…Specifically, we found nine cases of trigeminal neuralgia due to dural AV fistula[ 1 6 7 10 14 15 17 24 27 ] and five cases of association between trigeminal neuralgia and venous angioma of the posterior cranial fossa. [ 22 23 25 28 33 37 ] In all but one case,[ 7 ] the vascular malformation was suspected with preoperative imaging. In our case, vascular malformation was not suspected on the basis of the preoperative radiological assessment and intraoperative findings were not in favor of that.…”

Section: Discussionmentioning

confidence: 99%

Sacrificing the superior petrosal vein during microvascular decompression. Is it safe? Learning the hard way. Case report and review of literature

et al. 2016

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Background:Venous infarction as a complication of microvascular decompression (MVD) is a recognized but extremely rare occurrence in an otherwise standard neurosurgical procedure. Sacrificing one or more veins is considered safe by majority of experienced surgeons and authors. However, in the recent years, there has been growing debate about the management of venous trigeminal compression and/or superior petrosal complex (separation vs. coagulation and cutting of the vein), with few papers describing mild to severe complications related to venous sacrifice.Case Description:We report our dramatic experience during re-exploration for MVD on a male who developed massive cerebellar, brainstem, and brain infarction. Extensive analysis of surgical planning and literature debate about this topic is also reported.Conclusion:Despite rare, venous infarction after venous sacrifice in MVD is possible and can have catastrophic consequences. We would advise: (1) To try preserving the vein anytime this is possible, especially if it is large in size; (2) if it is decided to sacrifice the vein temporary occlusion while observing changed in the neurophysiology might be safer; (3) when planning an MVD for suspected venous compression, possible alternative forms of treatment should also be considered.

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Section: Discussionmentioning

confidence: 99%

Sacrificing the superior petrosal vein during microvascular decompression. Is it safe? Learning the hard way. Case report and review of literature

et al. 2016

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“…Of the cases of TN caused by a DVA with sufficient treatment descriptions in the literature, 5 were treated conservatively, 1 underwent glycerol rhizotomy and 10 underwent MVD [2,15]. Table 1 summarizes these cases.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there appear to be only 20 total reported cases [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Although microvascular decompression (MVD) is the favored surgical treatment of refractory TN, surgical disruption of a DVA can lead to severe neurological deficits or even death due to venous infarction [16].…”

Section: Introductionmentioning

confidence: 99%

Gamma Knife Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by a Developmental Venous Anomaly

Harrison

Lunsford²,

Monaco³

2015

Stereotact Funct Neurosurg

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Background: Trigeminal neuralgia (TN) is mostly caused by vascular compression of the nerve's root entry zone due to an ectatic artery. Rarer causes include compression from tumors, vascular malformations or multiple sclerosis plaques. Developmental venous anomalies (DVAs) are benign, aberrantly appearing venous structures that drain normal cerebral tissue. DVAs are a rare etiology of TN. The management of TN caused by a DVA is controversial as disruption of the DVA can be catastrophic. Methods: We report a case of a young man with severe medically refractory TN related to a brachium pontis DVA who was successfully treated by gamma knife stereotactic radiosurgery (GKSR) to the trigeminal nerve. Results: Within 2 weeks of GKSR, the patient reported experiencing 60% pain relief; 5 years postoperatively, he remains completely pain free with some mild sensory loss in the V2 and V3 areas. Conclusions: GKSR has an established role in the management of TN. This is the first reported case of using GKSR to treat TN caused by a DVA. In the setting of a DVA, GKSR should be an initial consideration for TN therapy after medical failure because of the high surgical risk related to disrupting the DVA.

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“…In some cases, the vessel that caused TN can be identified with MRI without the need for intensive conventional angiography (4,14,15). In the case of Yamamoto et al (19), 3-dimensional CT angiography was very useful in the diagnosis of venous malformation to detect the offending vessel. There are several options for treatment of TN caused by VA, such as medication, gamma knife radiotherapy, MVD, and rhizotomy (3,18,20).…”

Section: Literature Reviewmentioning

confidence: 99%

“…These veins do a necessary job of getting blood in and out of the brain, and therefore they do not need to be surgically removed or closed. According to our knowledge and literature review, there are only a few cases in which VA has caused TN (9,(11)(12)(13)19).…”

Section: Introductionmentioning

confidence: 99%