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Case Reports
Resolution of trigeminal neuralgia after transvenous embolization of a cavernous sinus dural arteriovenous fistula.
- Kenji Fukutome, Ichiro Nakagawa, Hun Soo Park, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, and Hiroyuki Nakase.
- Department of Neurosurgery, Nara Medical University, Nara, Japan.
- World Neurosurg. 2017 Feb 1; 98: 880.e5-880.e8.
BackgroundTrigeminal neuralgia (TN) resulting from a dural arteriovenous fistula (DAVF) are rare. A case of cavernous sinus dural arteriovenous fistula (CSDAVF) in a patient with TN that resolved immediately after transvenous embolization (TVE) is described.Case DescriptionA 75-year-old woman presented with continuous facial pain. On time-of-flight magnetic resonance angiography (MRA), a CSDAVF was suspected, and digital subtraction angiography (DSA) showed a CSDAVF. The TN completely resolved immediately after TVE, with no recurrence. Follow-up MRA showed complete obliteration of the fistula 13 months after TVE.ConclusionsThe pulsatile flow at the posteromedial part of the cavernous sinus might have compressed the upper aspect of the Gasserian ganglion, causing TN. Disappearance of pulsatile flow after TVE might result in complete resolution of TN.Copyright © 2016 Elsevier Inc. All rights reserved.
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