scholarly journals Giant intracavernous aneurysm presenting with isolated trigeminal neuralgia: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Fadhilah Hani Ishak ◽  
Abdul Hanif Khan Yusof Khan ◽  
Mohd Naim Mohd Yaakob ◽  
Mohd Fandi Al Khafiz Kamis ◽  
Anna Misyail Abdul Rashid ◽  
...  
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Mass Effect ◽  
Distal Portion ◽  
Neurovascular Compression ◽  
Cerebral Angiogram ◽  
Intracavernous Aneurysm ◽  
Mild Improvement ◽  
Aneurysm Embolization

Abstract Background Trigeminal neuralgia (TN) commonly affects individuals aged more than 50 years and is mostly primary owing to trigeminal nerve neurovascular compression. We report a case of secondary TN attributed to a giant intracavernous aneurysm compressing the trigeminal nerve. Case presentation A 74-year-old female presented with classic TN symptoms, which were initially refractory to medical treatment. Imaging including MRI brain, MR angiography, and cerebral angiogram revealed a giant intracavernous aneurysm measuring 1.7 cm × 2.8 cm, inducing mass effect on the left Meckel's cave. Aneurysm embolization was challenging due to the difficult cannulation of the distal portion of the aneurysm. The patient opted for conservative management with mild improvement of symptoms. Conclusions Intracavernous aneurysm rarely present with isolated trigeminal neuralgia. This case report emphasizes that the assessment of the intracranial vasculature should be considered as part of the diagnostic imaging work-up for patients presenting with TN

MRI features of responsible contacts in vascular compressive trigeminal neuralgia and prediction modeling

2021 ◽  
pp. 028418512098397
Author(s):  
Yufei Zhao ◽  
Jianhua Chen ◽  
Rifeng Jiang ◽  
Xue Xu ◽  
Lin Lin ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Predictive Model ◽  
Trigeminal Nerve ◽  
Roc Curve ◽  
Neurovascular Compression ◽  
Diagnostic Efficiency ◽  
Mri Features ◽  
Vascular Origin ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Characteristics

Background Multiple neurovascular contacts in patients with vascular compressive trigeminal neuralgia often challenge the diagnosis of responsible contacts. Purpose To analyze the magnetic resonance imaging (MRI) features of responsible contacts and establish a predictive model to accurately pinpoint the responsible contacts. Material and Methods Sixty-seven patients with unilateral trigeminal neuralgia were enrolled. A total of 153 definite contacts (45 responsible, 108 non-responsible) were analyzed for their MRI characteristics, including neurovascular compression (NVC) grading, distance from pons to contact (Dpons-contact), vascular origin of compressing vessels, diameter of vessel (Dvessel) and trigeminal nerve (Dtrigeminal nerve) at contact. The MRI characteristics of the responsible and non-responsible contacts were compared, and their diagnostic efficiencies were further evaluated using a receiver operating characteristic (ROC) curve. The significant MRI features were incorporated into the logistics regression analysis to build a predictive model for responsible contacts. Results Compared with non-responsible contacts, NVC grading and arterial compression ratio (84.44%) were significantly higher, Dpons-contact was significantly lower at responsible contacts ( P < 0.001, 0.002, and 0.033, respectively). NVC grading had a highest diagnostic area under the ROC curve (AUC) of 0.742, with a sensitivity of 64.44% and specificity of 75.00%. The logistic regression model showed a higher diagnostic efficiency, with an AUC of 0.808, sensitivity of 88.89%, and specificity of 62.04%. Conclusion Contact degree and position are important MRI features in identifying the responsible contacts of the trigeminal neuralgia. The logistic predictive model based on Dpons-contact, NVC grading, and vascular origin can qualitatively improve the prediction of responsible contacts for radiologists.

scholarly journals A Novel Case of Resolved Postherpetic Neuralgia with Subsequent Development of Trigeminal Neuralgia: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Alexander Mason ◽  
Kristen Ayres ◽  
Sigita Burneikiene ◽  
Alan T. Villavicencio ◽  
E. Lee Nelson ◽  
...  
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Trigeminal Neuralgia ◽  
Female Patient ◽  
Trigeminal Nerve ◽  
Postherpetic Neuralgia ◽  
Subsequent Development ◽  
Review Of The Literature ◽  
Trigeminal Pain ◽  
Ophthalmic Branch

A 72-year-old female patient is presented, who was diagnosed with herpes zoster along the left ophthalmic branch of the trigeminal nerve with associated cutaneous vesicles. The patient subsequently developed postherpetic neuralgia in the same dermatome, which, after remission, transformed into paroxysmal trigeminal pain. The two different symptom sets, with the former consistent with PHN and the later consistent with trigeminal neuralgia, were unique to our practice and the literature.

TRIGEMINAL NEURALGIA AND VASCULAR COMPRESSION IN PATIENTS WITH TRIGEMINAL SCHWANNOMAS

Neurosurgery ◽  
2008 ◽  
Vol 62 (4) ◽  
pp. E974-E975 ◽  
Author(s):  
Jonathan P. Miller ◽  
Feridun Acar ◽  
Kim J. Burchiel
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Gamma Knife Radiosurgery ◽  
Vascular Compression ◽  
Neurovascular Compression ◽  
Intracranial Tumors ◽  
Resonance Imaging

Abstract OBJECTIVE Trigeminal neuralgia (TN) is often associated with neurovascular compression. However, intracranial tumors are occasionally observed, particularly when symptoms are atypical. We describe three patients with Type-1 TN and trigeminal schwannoma diagnosed by magnetic resonance imaging, with concomitant arterial compression of the trigeminal nerve. CLINICAL PRESENTATION All three patients had Type-1 TN with spontaneous onset, paroxysm-triggered pain, and response to antiepileptic medication. Contrast-enhanced T1-weighted magnetic resonance imaging scans demonstrated an ipsilateral enhancing perineural mass consistent with a schwannoma. Two of the three patients had previously undergone gamma knife radiosurgery without improvement. Subsequent high-resolution magnetic resonance imaging in all three patients revealed obvious compression of the trigeminal nerve by an arterial structure. INTERVENTION Two patients underwent retrosigmoid craniectomy followed by microvascular decompression and remain pain-free. One patient elected not to pursue surgical intervention. CONCLUSION Although intracranial tumors are occasionally observed in patients with TN, neurovascular compression must still be considered as an etiology, especially if typical TN symptoms are reported.

scholarly journals To be or not to be a neurovascular conflict: importance of the preoperative identification of the neurovascular conflict in the trigeminal neuralgia

2016 ◽  
Vol 30 (3) ◽  
pp. 336-344
Author(s):  
Dana Mihaela Turliuc ◽  
B. Dobrovăţ ◽  
A. I. Cucu ◽  
Ş. Turliuc ◽  
Daniela Trandafir ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Surgical Approach ◽  
Neurovascular Compression ◽  
Neurovascular Conflict

Abstract The trigeminal neuralgia caused by neurovascular compression is a neurosurgical pathology requiring the preoperative identification as exact as possible of the neurovascular conflict. In this case, neuroimaging is very useful, as it allows not only the determination of the neurovascular conflict of the trigeminal nerve, but also the correct indication of an adequate surgical approach.

Familial Osteodysplasia Associated with Trigeminal Neuralgia: Case Report

Neurosurgery ◽  
1984 ◽  
Vol 15 (4) ◽  
pp. 562-565 ◽  
Author(s):  
Kyo Huang Niijima ◽  
Akinori Kondo ◽  
Jun-ichiro Ishikawa ◽  
Choigon Kim ◽  
Hiraji Itoh
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Short Stature ◽  
Trigeminal Nerve ◽  
Basilar Artery ◽  
Cerebellopontine Angle ◽  
Basilar Impression ◽  
Vertebral Angiography ◽  
Facial Spasm ◽  
Possible Cause

Abstract A 24-year-old woman suffering from left trigeminal neuralgia presented with the familial occurrence of skeletal anomalies simulating Hajdu-Cheney syndrome. She was of a short stature and had low-set ears, protrusion of the bilateral temporal and occipital bones, platybasia, basilar impression, and dental anomaly. Vertebral angiography disclosed marked displacement to the left and dorsally of the basilar artery, which was confirmed during the operation to have compressed the left trigeminal nerve in the cerebellopontine angle narrowed by the unusually protruded bony structure. Cases of Hajdu-Cheney syndrome have occasionally been reported, a few combined with facial spasm, but Hajdu-Cheney syndrome with trigeminal neuralgia is very rate. The patient's family members were surveyed. The possible cause of the neuralgia with its relation to the osteodysplasia is briefly discussed.

Trigeminal neuralgia resulting from auditory brainstem implant cable compression

2011 ◽  
Vol 114 (1) ◽  
pp. 186-188 ◽  
Author(s):  
Marc S. Schwartz ◽  
Derald E. Brackmann ◽  
Eric P. Wilkinson ◽  
John L. Go ◽  
Felipe Santos
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Imaging Study ◽  
Neurofibromatosis Type ◽  
Auditory Brainstem ◽  
Fast Imaging ◽  
Neurovascular Compression ◽  
Auditory Brainstem Implant ◽  
Maximal Medical Therapy

The authors report a case of neurofibromatosis Type 2 presenting with symptoms of trigeminal neuralgia refractory to medical management following placement of an auditory brainstem implant (ABI). Physical examination and history revealed trigeminal neuralgia. A 3D FIESTA (fast imaging employing steady-state acquisition) MR imaging study demonstrated compression of the trigeminal nerve by an ABI cable. After maximal medical therapy, a retrosigmoid microscopic decompression of the trigeminal nerve achieved complete symptom resolution. This is the first report of an ABI cable becoming displaced, resulting in neurovascular compression. This case demonstrates that trigeminal neuralgia can result from nonvascular compression of the trigeminal nerve.

scholarly journals Cluster-Tic or Tic-Cluster? Trigeminal Neuralgia (Tic) Turning to Trigeminal Autonomic Cephalalgia (TAC) Following Venous Decompression of the Trigeminal Nerve: A Case Report and Review of the Literature

2019 ◽  
Author(s):  
Patrick M. Chen ◽  
Sharona Ben-Haim ◽  
Jason Handwerker ◽  
Hossein Ansari
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
New Left ◽  
Trigeminal Autonomic Cephalalgia ◽  
Venous Compression ◽  
Clinical Presentations ◽  
Paroxysmal Pain

Abstract Objective: We present a rare case of Tic-cluster in the context of venous compression of the trigeminal nerve. Background: Cluster-Tic syndrome is a rare headache condition with features of both trigeminal neuralgia (Tic) and trigeminal autonomic cephalalgia symptom (TAC). Methods: Case report and review of literature. Results: A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic). Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion. He underwent microvascular decompression which confirmed petrosal vein compression with subsequent symptomatic resolution. After two years of remission, he had a new left unilateral throbbing headache consistent with International Classification of Headache Disorders (ICHD)- 3 cluster headache definition, which improved with steroids. Conclusion: Cluster-Tic syndrome has variable clinical presentations. Tic can precede cluster and the possible role of venous trigeminal compression in this headache remains unclear.

Hypertrophic Interstitial Neuropathy of the Trigeminal Nerve: Case Report and Literature Review

Neurosurgery ◽  
2019 ◽  
Vol 87 (1) ◽  
pp. E41-E47 ◽  
Author(s):  
Alick P Wang ◽  
Dragos Catana ◽  
John P Provias ◽  
Kesava K V Reddy
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Peripheral Nerves ◽  
Complete Resolution ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
The Third ◽  
Neoplastic Lesion ◽  
Microscope Images

Abstract BACKGROUND AND IMPORTANCE Hypertrophic interstitial neuropathy (HIN) is an uncommon, non-neoplastic lesion typically affecting peripheral nerves. Cranial nerve (CN) involvement is exceedingly rare. We present a case of isolated trigeminal nerve HIN manifesting with V3 distribution neuralgia. CLINICAL PRESENTATION A 50-yr-old male presented with left sided trigeminal neuralgia refractory to medical management. The patient underwent retromastoid craniectomy for possible microvascular decompression. Intra-operatively, the trigeminal nerve appeared to be focally enlarged with a sausage-like configuration. We selectively resected 1 fascicle which was predominantly involved. Histopathological examination revealed onion bulb formations composed of Schwann cells around centrally placed axons. A diagnosis of HIN was made. Postoperatively, the patient experienced complete resolution of symptoms. CONCLUSION This is the third case of isolated trigeminal nerve HIN in the literature. We performed a selective resection in a patient presenting with trigeminal neuralgia, resulting in complete resolution of symptoms. It is reported here with intraoperative microscope images, along with a review and analysis of this topic as it related to CN.

scholarly journals P.083 Trigeminal neuralgia caused by an intra-axial glioma in a child: first surgical case report and systematic review

2016 ◽  
Vol 43 (S2) ◽  
pp. S40-S40
Author(s):  
R Bokhari ◽  
S Baeesa ◽  
A Sabbagh ◽  
J Atkinson ◽  
R Dudley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Substantial Improvement ◽  
Subtotal Resection ◽  
Incomplete Resection ◽  
Neurophysiologic Monitoring ◽  
Spinal Nucleus

Background: Trigeminal neuralgia (TGN) is usually caused by arterial compression of the trigeminal nerve. There are very few cases caused by intra-axial brainstem masses. Little information is therefore available regarding the response to incomplete resection of offending lesions. We present one such case, and systematically review the published in the literature. Methods: Case report and systematic review of MEDLINE and EMBASE Results: Case report: A seven year-old girl is referred with typical TGN pain. MRI revealed a cervicomedullary tumor with no abnormalities of the pons or trigeminal nerve. Subtotal resection under neurophysiologic monitoring was achieved, leaving a small residual attached near the expected location of the trigeminal spinal nucleus and tract.Patient recovered well with resolution of her TGN pain. She is asymptomatic seven years post-operatively. Literature Review: We found no other published cases in children or secondary to gliomas. Among reviewed cases, only two underwent surgery. Both were adults with brainstem cavernomas and both reported substantial improvement despite incomplete resection. Conclusions: Our case as well as literature review both show that surgical resection is beneficial in such cases and, even if subtotal, can result in substantial pain relief. This suggests intra-axial compression of the trigeminal spinal nucleus and tract as the possible cause of TGN pain in such cases.

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