Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave: Case report

Rose Du, Devin K. Binder, Van Halbach, Nancy Fischbein, Nicholas Barbaro, Kim J. Burchiel, Michael Sandquist, Marc P. Sindou, Chad J. Morgan, John M. Tew

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Trigeminal neuralgia is often the result of vascular compression at the root entry zone of the trigeminal nerve. We report a case of trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave. Endovascular closure of the fistula resulted in elimination of the patient's pain at the gasserian ganglion level. CLINICAL PRESENTATION: A 77-year-old woman was referred for treatment of trigeminal neuralgia after failed conservative treatment, including multiple gasserian ganglion blocks. Magnetic resonance imaging of the brain suggested a vascular lesion, and cerebral angiography demonstrated a dural arteriovenous fistula in Meckel's cave. INTERVENTION: Endovascular coil embolization was performed, with obliteration of the dural arteriovenous fistula and resolution of facial pain but with decreased sensation in the face. CONLUSION: Trigeminal neuralgia may be associated with complex vascular lesins around the base of the brain and along the course of the trigeminal nerve. The evaluation of patients with trigeminal neuralgia should include high-quality, thinsection, magnetic resonance imaging scans, to exclude the possibility of vascular lesions and other structural lesions in particular, patients who are being evaluated for surgical treatment of trigeminal neuralgia should undergo magnetic resonance imaging, with a focus on the course of the trigeminal nerve.

Original languageEnglish (US)
Pages (from-to)216-221
Number of pages6
JournalNeurosurgery
Volume53
Issue number1
StatePublished - Jul 1 2003
Externally publishedYes

Fingerprint

Central Nervous System Vascular Malformations
Trigeminal Neuralgia
Trigeminal Nerve
Blood Vessels
Trigeminal Ganglion
Magnetic Resonance Imaging
Cerebral Angiography
Facial Pain
Brain
Fistula
Pain
Therapeutics

Keywords

  • Dural arteriovenous fistula
  • Embolization
  • Microvascular surgery
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Du, R., Binder, D. K., Halbach, V., Fischbein, N., Barbaro, N., Burchiel, K. J., ... Tew, J. M. (2003). Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave: Case report. Neurosurgery, 53(1), 216-221.

Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave : Case report. / Du, Rose; Binder, Devin K.; Halbach, Van; Fischbein, Nancy; Barbaro, Nicholas; Burchiel, Kim J.; Sandquist, Michael; Sindou, Marc P.; Morgan, Chad J.; Tew, John M.

In: Neurosurgery, Vol. 53, No. 1, 01.07.2003, p. 216-221.

Research output: Contribution to journalArticle

Du, R, Binder, DK, Halbach, V, Fischbein, N, Barbaro, N, Burchiel, KJ, Sandquist, M, Sindou, MP, Morgan, CJ & Tew, JM 2003, 'Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave: Case report', Neurosurgery, vol. 53, no. 1, pp. 216-221.
Du R, Binder DK, Halbach V, Fischbein N, Barbaro N, Burchiel KJ et al. Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave: Case report. Neurosurgery. 2003 Jul 1;53(1):216-221.
Du, Rose ; Binder, Devin K. ; Halbach, Van ; Fischbein, Nancy ; Barbaro, Nicholas ; Burchiel, Kim J. ; Sandquist, Michael ; Sindou, Marc P. ; Morgan, Chad J. ; Tew, John M. / Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave : Case report. In: Neurosurgery. 2003 ; Vol. 53, No. 1. pp. 216-221.
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