• Isao Kitahara, Ataru Fukuda, Yoshiki Imamura, Masako Ikawa, and Tomoki Yokochi.
• Department of Neurosurgery, Chiba Tokushukai Hospital, Funabashi, Japan. Electronic address: isao.k@tokushukai.jp.
• World Neurosurg. 2015 Oct 1;84(4):1080-3.

BackgroundShort-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) are characterized by attacks of moderate to severe stabbing pain, strictly unilateral, with periorbital or temporal distribution, associated with cranial autonomic symptoms, such as lacrimation and redness of the ipsilateral eye.MethodsTo obtain mechanistic insights into the pathogenesis of SUNCT syndrome, more than 800 cases treated in our institution during the last 7 years were retrospectively reviewed. Two patients showed typical autonomic symptoms of SUNCT.ResultsMagnetic resonance imaging suggested potential compression of the trigeminal nerve by the intracranial artery in these cases and complete remission was achieved by microvascular decompression.ConclusionsMicrovascular decompression provides an appropriate therapeutic choice if vascular compression of the trigeminal nerve is identified. From our 2 cases, we propose that, in some cases of SUNCT diagnosed previously, characteristic symptoms were induced by compression of the side surface of the first branch of the trigeminal nerve at the root exit zone by the intracranial artery.Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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