engleski

Microsurgical Decompression of Trigeminal Neuralgia Caused by Simultaneous Double Arterial (SCA and AICA) and Petrosal Vein Complex Compression.

Trigeminal neuralgia is most commonly caused by compression of Superior cerebellar artery (SCA) to the root entry zone (REZ) of the trigeminal nerve in about 80% of cases. The etiology of remaining 20% is distributed among venous, AVM malformations, posterior fossa tumors and Multiple sclerosis (MS) plaque compressions and other pathology. Combinations of those compressive factors are very rare.1-4 Herein we present a video clip of microvascular decompression (MVD) of unique triple compression of the right REZ by SCA, Anterior inferior cerebellar artery (AICA) and Petrosal vein complex in a 73 year`s old lady who has failed 10 years of conservative treatment on 6 medications. Right sided microsurgical decompression of REZ of the trigeminal nerve through standard retrosigmoid craniotomy was performed by the senior author (KIA). SCA and AICA were separated from the nerve using Teflon pledgets. Petrosal vein complex was coagulated and divided freeing up the right trigeminal nerve. Patient was discharged home on the third postoperative day, with complete resolution of trigeminal neuralgia.

arterial compression ; microvascular decompression ; suboccipital craniotomy ; trigeminal neuralgia ; venous compression

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