Atrophy and severe kinking of trigeminal nerve root by duplicate

World Neurosurg · Nov 2023

Atrophy and severe kinking of trigeminal nerve root by duplicate trunks of superior cerebellar artery in an elderly patient with trigeminal neuralgia.

Trigeminal neuralgia, or tic douloureux, clinically presents as a unilateral paroxysmal, stabbing, intense pain of the face, lasting for seconds but occurring frequently. Alternative causes including multiple sclerosis or mass of the brainstem or cranial nerves must be ruled out. ⋯ Ultimately, if medical management becomes refractory or symptoms progressive, then procedural and surgical options including microvascular decompression, stereotactic radiosurgery, radiofrequency thermocoagulation, and others should be considered. Most notably, microvascular decompression, as in this case, can be considered with an 85%-95% initial success rate.

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- Joseph A Carnevale and Jared Knopman.
- Department of Neurological Surgery, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York, USA. Electronic address: joseph.carnevale.md@gmail.com.
- World Neurosurg. 2023 Nov 1; 179: 100101100-101.
AbstractTrigeminal neuralgia, or tic douloureux, clinically presents as a unilateral paroxysmal, stabbing, intense pain of the face, lasting for seconds but occurring frequently. Alternative causes including multiple sclerosis or mass of the brainstem or cranial nerves must be ruled out. Medical treatment, most commonly with carbamazepine, remains an effective first-line treatment. Ultimately, if medical management becomes refractory or symptoms progressive, then procedural and surgical options including microvascular decompression, stereotactic radiosurgery, radiofrequency thermocoagulation, and others should be considered. Most notably, microvascular decompression, as in this case, can be considered with an 85%-95% initial success rate.Copyright © 2023 Elsevier Inc. All rights reserved.

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Atrophy and severe kinking of trigeminal nerve root by duplicate trunks of superior cerebellar artery in an elderly patient with trigeminal neuralgia.

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