Format

Send to

Choose Destination
World Neurosurg. 2019 Feb;122:607-612. doi: 10.1016/j.wneu.2018.11.177. Epub 2018 Nov 27.

Trigeminal Neuralgia Caused by Dural Arteriovenous Fistula in Meckel Cave Treated with Gamma Knife Radiosurgery.

Author information

1
Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA.
2
Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA.
3
Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA.
4
Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA.
5
Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: middlebrooks.erik@mayo.edu.

Abstract

BACKGROUND:

Classic 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 DESCRIPTION:

A 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.

CONCLUSIONS:

This 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.

KEYWORDS:

Dural arteriovenous fistula; Gamma knife radiosurgery; Meckel cave; Stereotactic radiosurgery with gamma knife; Trigeminal neuralgia

PMID:
30500585
DOI:
10.1016/j.wneu.2018.11.177
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center