• Atul Goel, Tejas Vaja, Abhidha Shah, Saswat Dandpat, and Nilesh Bakale.
• Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India; Lilavati Hospital and Research Centre, Bandra (E), Mumbai, India. Electronic address: atulgoel62@hotmail.com.
• World Neurosurg. 2019 Sep 1; 129: 437-439.

BackgroundTrigeminal neuralgia can rarely be identified in association with basilar invagination. The presented case report observes that the treatment of basilar invagination by atlantoaxial fixation can result in lasting relief from trigeminal neuralgia.Case DescriptionWe report a case of a 36-year-old male patient who presented with the primary symptom of trigeminal neuralgia for a period of 2 years. Investigations revealed the presence of basilar invagination and an ectatic vertebral artery loop in the vicinity of the trigeminal nerve. The patient underwent atlantoaxial fixation on the basis of the concept that atlantoaxial instability is the nodal point of pathogenesis of basilar invagination. Atlantoaxial fixation resulted in complete and lasting relief from symptom of trigeminal neuralgia.ConclusionsThe pathogenesis of trigeminal neuralgia and its relationship with atlantoaxial instability is speculated.Copyright © 2019 Elsevier Inc. All rights reserved.

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