Trigeminal neuralgia associated with a primitive trigeminal artery variant: Case report

Yoji Tamura, Hiroshi Shimano, Toshihiko Kuroiwa, Yoshihito Miki, Nicholas M. Barbaro, Kim J. Burchiel, Michael Sandquist, Akira Yamaura, Iwao Yamakami, Christopher C. Getch

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

OBJECTIVE AND IMPORTANCE: A variant type of the primitive trigeminal artery (PTA) is a rare anomalous vessel that originates from the internal carotid artery and directly supplies the territory of the anteroinferior cerebellar artery and/or the superior cerebellar artery. We report a case of trigeminal neuralgia associated with this PTA variant, and we discuss the characteristics of this vessel. CLINICAL PRESENTATION: A 51-year-old woman presented with a 10-year history of left paroxysmal facial pain. Magnetic resonance angiography and cerebral angiography demonstrated that an aberrant vessel originating from the left internal carotid artery directly supplied the cerebellum, without a basilar artery anastomosis. INTERVENTION: Surgical exploration was performed via a left retrosigmoid approach. A loop of the aberrant vessel, which entered the posterior fossa through the isolated dural foramen, was compressing the trigeminal nerve. This aberrant vessel was displaced medially from the nerve with a prosthesis, with care to avoid kinking and avulsion of the perforating arteries. The patient's neuralgia resolved postoperatively. CONCLUSION: Although the PTA variant is frequently associated with intracranial aneurysms, it is extremely rare for the variant to lead to trigeminal neuralgia. During microvascular decompression surgery, surgeons should be careful to prevent injury of the perforating arteries arising from the PTA variant.

Original languageEnglish (US)
Pages (from-to)1217-1220
Number of pages4
JournalNeurosurgery
Volume52
Issue number5
StatePublished - May 1 2003

Keywords

  • Microvascular decompression
  • Primitive trigeminal artery
  • Trigeminal neuralgia
  • Variant type

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Tamura, Y., Shimano, H., Kuroiwa, T., Miki, Y., Barbaro, N. M., Burchiel, K. J., Sandquist, M., Yamaura, A., Yamakami, I., & Getch, C. C. (2003). Trigeminal neuralgia associated with a primitive trigeminal artery variant: Case report. Neurosurgery, 52(5), 1217-1220.