Trigeminal Neuralgia Due to Anterior Inferior Cerebellar Artery Loop: A Case Report

2009 ◽  
Vol 24 (8) ◽  
pp. 989-990
Author(s):  
Roshan Koul ◽  
Amna Alfutaisi ◽  
Rajeev Jain ◽  
Faisal Alzri
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Anterior Inferior Cerebellar Artery ◽  
Cerebellar Artery

scholarly journals Percutaneous radiofrequency treatment of the gasserian ganglion for trigeminal neuralgia complicated by trochlear nerve palsy: a case report

2021 ◽  
pp. rapm-2020-102285
Author(s):  
Pascal SH Smulders ◽  
Michel AMB Terheggen ◽  
José W Geurts ◽  
Jan Willem Kallewaard
Keyword(s):  
Trigeminal Neuralgia ◽  
Cranial Nerve ◽  
Facial Pain ◽  
Anatomical Variations ◽  
Anterior Inferior Cerebellar Artery ◽  
Gasserian Ganglion ◽  
Radiofrequency Treatment ◽  
Experienced Pain ◽  
Cerebellar Artery ◽  
Trochlear Nerve Palsy

BackgroundTrigeminal neuralgia (TN) has the highest incidence of disorders causing facial pain. TN is provoked by benign stimuli, like shaving, leading to severe, short-lasting pain. Patients are initially treated using antiepileptic drugs; however, multiple invasive options are available when conservative treatment proves insufficient. Percutaneous radiofrequency treatment of the trigeminal, or gasserian, ganglion (RF-G) is a procedure regularly used in refractory patients with comorbidities. RF-G involves complex needle maneuvering to perform selective radiofrequency heat treatment of the affected divisions. We present a unique case of cranial nerve 4 (CN4) paralysis after RF-G.Case presentationA male patient in his 60s presented with sharp left-sided facial pain and was diagnosed with TN, attributed to the maxillary and mandibular divisions. MRI showed a vascular loop of the anterior inferior cerebellar artery without interference of the trigeminal complex. The patient opted for RF-G after inadequate conservative therapy. The procedure was performed by an experienced pain physician and guided by live fluoroscopy. The patient was discharged without problems but examined the following day for double vision. Postprocedural MRI showed enhanced signaling between the trigeminal complex and the brainstem. Palsy of CN4 was identified by a neurologist, and spontaneous recovery followed 5 months after the procedure.ConclusionsMention of postprocedural diplopia in guidelines is brief, and the exact incidence remains unknown. Different mechanisms for cranial nerve (CN) palsy have been postulated: incorrect technique, anatomical variations, and secondary heat injury. We observed postprocedural hemorrhage and hypothesized that bleeding might be a contributing factor in injury of CNs after RF-G.

scholarly journals Anterior Inferior Cerebellar Artery Syndrome Followed by Facial Nerve Paralysis; A Case Report.

1993 ◽  
Vol 86 (3) ◽  
pp. 315-320 ◽  
Author(s):  
Meiho Nakayama ◽  
Shigeru Inafuku ◽  
Isao Takimoto ◽  
Kaoru Suzuki ◽  
Noboru Matsumoto ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Anterior Inferior Cerebellar Artery ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Cerebellar Artery

scholarly journals CPA Epidermoid Cyst with Rare Anatomic Variant: Anterior Inferior Cerebellar Artery Embedded in the Subarcuate Fossa: Operative Video and Technical Nuances

2018 ◽  
Vol 80 (S 03) ◽  
pp. S323-S324
Author(s):  
Carlos Candanedo ◽  
Sergey Spektor
Keyword(s):  
Trigeminal Neuralgia ◽  
Epidermoid Cyst ◽  
Abducens Nerve ◽  
Residual Tumor ◽  
Benign Tumors ◽  
Anterior Inferior Cerebellar Artery ◽  
Surgical Removal ◽  
Anatomical Variant ◽  
Cerebellar Artery ◽  
Subarcuate Artery

Intracranial epidermoid cysts are considered benign tumors with a good general prognosis; however, their radical removal, including tumor capsule, is associated with significant morbidity, especially when the capsule is attached to neurovascular structures. We show an operative video describing main steps and surgical nuances in the resection of a large right cerebellopontine angle (CPA) epidermoid cyst in a 42-year-old male patient who presented with intractable trigeminal neuralgia. Craniectomy was performed to exposure the transverse-sigmoid sinus junction. A mold for a polymethylmethacrylate (PMMA) bone flap was built before opening the dura to avoid potentially neurotoxic effects on the cerebellum. The video illustrates the management of the rare anatomical variant of the anterior inferior cerebellar artery (AICA). Its loop was embedded in the dura, covering the subarcuate fossa where it gives off the subarcuate artery. Near total removal of the epidermoid cyst was achieved, leaving only a tiny capsule remnant adhering to the abducens nerve. Postoperatively the patient's trigeminal neuralgia was fully relieved and medications were discontinued. The patient's hearing was preserved per audiometry at the preoperative level (Gardner–Robertson II). Postoperative magnetic resonance imaging (MRI) revealed no signs of residual tumor. In this case, it was not possible to obtain optimal surgical exposure of the CPA without handling a rare anatomical anomaly of the AICA in the dura of the subarcuate fossa, which demanded coagulation and transection of the subarcuate artery and transposition of AICA with the dural cuff. This manipulation enabled optimal surgical removal of the epidermoid and didn't cause any neurological deficit.The link to the video can be found at: https://youtu.be/lLZqBHlu-uA.

scholarly journals Aneurysm of the Distal Anterior Inferior Cerebellar Artery —Case Report—

1995 ◽  
Vol 35 (8) ◽  
pp. 587-590 ◽  
Author(s):  
Shunichi YOKOYAMA ◽  
Koki KADOTA ◽  
Tetsuhiko ASAKURA ◽  
Kazumasa KAWAZOE
Keyword(s):  
Case Report ◽  
Anterior Inferior Cerebellar Artery ◽  
Cerebellar Artery

Acute unilateral sensorineural hearing loss associated with anabolic steroids and polycythaemia: case report

2015 ◽  
Vol 130 (3) ◽  
pp. 309-313 ◽  
Author(s):  
T Tikka ◽  
N Mistry ◽  
A Janjua
Keyword(s):  
Risk Factors ◽  
Hearing Loss ◽  
Case Report ◽  
Sensorineural Hearing Loss ◽  
Anabolic Steroids ◽  
Sensorineural Hearing ◽  
Anterior Inferior Cerebellar Artery ◽  
Coronary Risk Factors ◽  
Management Protocol ◽  
Cerebellar Artery

AbstractBackground:Unilateral sudden sensorineural hearing loss due to an infarct in the vertebrobasilar system has been widely reported. Most patients have a background of traditional coronary risk factors related to these cerebrovascular episodes.Case report:A 32-year-old male, a regular user of anabolic steroids, presented to the emergency department with unilateral sensorineural hearing loss and symptoms suggestive of an infarct of the anterior inferior cerebellar artery but in the absence of risk factors for ischaemic stroke.Results:Magnetic resonance imaging confirmed the presence of infarction in the region supplied by the anterior inferior cerebellar artery. Polycythaemia was found on haematological analysis, which we believe was secondary to the use of anabolic steroids. The patient was commenced on aspirin as per the stroke management protocol. There was resolution of neurological symptomatology six weeks after the episode, but no improvement in hearing.Conclusion:To our knowledge, this is the first case report of unilateral sensorineural hearing loss secondary to the use of anabolic steroids causing polycythaemia. This cause should be considered in the differential diagnosis of patients presenting with sensorineural hearing loss, especially in young males, when no other risk factors can be identified.

scholarly journals Microvascular Decompression by Interposition Method for Treatment of Trigeminal Neuralgia Due to Vertebrobasilar Dolichoectasia: A Retrospective Single-Center Study

2021 ◽  
Author(s):  
Feng Yu ◽  
Jia Yin ◽  
Pei-gang Lu ◽  
Zhen-yu Zhao ◽  
Yong-qiang Zhang ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Long Term Results ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Symptom Duration ◽  
Free Survival ◽  
Kaplan Meier ◽  
Vertebrobasilar Dolichoectasia ◽  
Cerebellar Artery

Abstract Trigeminal neuralgia (TN) due to vertebrobasilar dolichoectasia (VBD) is a rare disease that can be challenging to treat. The objectives of this study are to investigate the characteristics of patients with TN due to VBD and to analyze the efficacy of microvascular decompression (MVD) by the interposition method for treatment of the condition. From 2010 till 2020, the data of 30 patients with TN due to VBD who were treated with MVD by the interposition method were analyzed retrospectively. The characteristics of the patients were compared with those of patients with non-VBD TN (n = 815). Kaplan–Meier survival analysis was performed to determine pain-free survival. The 30 patients (21 males, 9 females; mean age, 63.03 years) accounted for 3.55% of all patients with TN during the study period. In 30 patients, the offending vessel was the basilar artery (BA) in 1 patient, the vertebral artery (VA) in 6 patients, the VA plus the superior cerebellar artery (SCA) in 6 patients, the VA plus the anterior inferior cerebellar artery (AICA) in 12 patients, and the VA+SCA+AICA in 5 patients. Compared to non-VBD TN patients, those with TN due to VBD were significantly more likely to be male, to have TN of the left side, and to have hypertension (all P < 0.001). Mean age at surgery (P = 0.057) and symptom duration (P = 0.308) were comparable between the two groups. All 30 patients had immediate relief of facial pain after MVD and could stop medication. There were no postoperative complications. Over mean follow-up of 76.67 months, 3 patients had recurrence. The mean duration of pain-free survival was 70.77 months. In conclusions, TN due to VBD appears to be more likely in males, in those with hypertension, and to involve the left side. The interposition method performed by experienced and skilled neurosurgeons is a safe and effective treatment for TN due to VBD. Further studies are needed to analyze the associated long-term results and the pain recurrence rate among this special population.

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