• Lela Okromelidze, George Vilanilam, Vivek Gupta, Daniel M Trifiletti, Benjamin L Brown, and Erik H Middlebrooks.
• Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA.
• World Neurosurg. 2019 Feb 1; 122: 607-612.

BackgroundClassic trigeminal neuralgia is an often debilitating condition that frequently results from vascular compression at the root entry zone of the trigeminal nerve. We report a case of dural arteriovenous fistula surrounding the trigeminal nerve from near the root entry zone extending as far ventral as the Meckel cave treated solely with Gamma Knife radiosurgery.Case DescriptionA 71-year-old woman presented with a history of persistent attacks of right facial pain after failed conservative management. Magnetic resonance imaging of the brain demonstrated dilated vasculature in the right cerebellopontine angle, and diagnostic cerebral angiography revealed a dural arteriovenous fistula surrounding the right trigeminal nerve. Stereotactic radiosurgery using Gamma Knife was performed. At 6-month follow-up, she was symptom-free with decreased caliber of abnormal vascularity surrounding the trigeminal nerve on magnetic resonance imaging.ConclusionsThis case suggests that trigeminal neuralgia associated with dural arteriovenous fistula can potentially be treated with Gamma Knife radiosurgery; however, more extensive studies and long-term follow-up to evaluate vessel patency will be necessary to elucidate further the role of stereotactic radiosurgery alone in treating this entity.Copyright © 2018 Elsevier Inc. All rights reserved.

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