Trigeminal neuralgia and vascular compression in patients with trigeminal schwannomas

Jonathan P. Miller, Feridun Acar, Kim J. Burchiel

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

OBJECTIVE: Trigeminal neuralgia (TN) is often associated with neurovascular compression. However, intracranial tumors are occasionally observed, particularly when symptoms are atypical. We describe three patients with Type-1 TN and trigeminal schwannoma diagnosed by magnetic resonance imaging, with concomitant arterial compression of the trigeminal nerve. CLINICAL PRESENTATION: All three patients had Type-1 TN with spontaneous onset, paroxysm-triggered pain, and response to antiepileptic medication. Contrast-enhanced T1-weighted magnetic resonance imaging scans demonstrated an ipsilateral enhancing perineural mass consistent with a schwannoma. Two of the three patients had previously undergone gamma knife radiosurgery without improvement. Subsequent high-resolution magnetic resonance imaging in all three patients revealed obvious compression of the trigeminal nerve by an arterial structure. INTERVENTION: Two patients underwent retrosigmoid craniectomy followed by microvascular decompression and remain pain-free. One patient elected not to pursue surgical intervention. CONCLUSION: Although intracranial tumors are occasionally observed in patients with TN, neurovascular compression must still be considered as an etiology, especially if typical TN symptoms are reported.

Original languageEnglish (US)
Pages (from-to)E974-E975
JournalNeurosurgery
Volume62
Issue number4
DOIs
StatePublished - Apr 1 2008

Keywords

  • Arterial compression
  • Magnetic resonance imaging
  • Trigeminal neuralgia
  • Trigeminal schwannomas

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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