Trigeminal neuralgia secondary to arteriovenous malformations of the posterior fossa

Pathology of the Trigeminal Nerve

“…6,29,30 Rarely, the conflicting vessel is a petrous vein, a saccular aneurysm, a persistent trigeminal artery, or an AVM. 31,32 Recently, it has been shown that the size of the cerebellopontine cistern, as measured with MR imaging, may play a role in favoring a neurovascular conflict, because a significantly smaller volume of the cistern was found in patients who had TN on the affected side. 33 Because contact between the cisternal portion of the trigeminal nerve and a blood vessel may also be seen in asymptomatic patients, the diagnosis of a neurovascular conflict should only be made at MR imaging with caution.…”

Trigeminal neuralgia due to arterialization of the superior petrosal vein in the context of dural or cerebral arteriovenous shunt

“…23 Since this first description, we found in Pubmed database 22 cases of TN secondary to bAVM or dAVF. Most of them were isolated cases except for two small series 6,10 . After analyzing these articles, we found 6 cases of cryptic AVM of the trigeminal nerve DREZ 3, 14-16, 19, 20 .…”

“…2 The association between trigeminal neuralgia and arteriovenous shunt of cerebrum or dura has been reported in few cases only. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] Isolated cases reported good pain reversibility after embolization, 4,7,8,10,13, 15 surgery 2, 5, 6 or radiotherapy. 3,11,16 We report our cases of symptomatic trigeminal neuralgia secondary to brain arteriovenous malformation (bAVM) or dural arteriovenous fistula (DAVF) in order to understand the pathophysiology, the structure that compresses the nerve (in case of compression) and factors influencing the presence of the neuralgia.…”

Trigeminal neuralgia

“…Compression of the trigeminal nerve resulting in paroxysmal pain has been described in exceptional cases of Chiari malformation [15], Dandy-Walker cyst [16], and glioblastoma [17]. Posterior fossa arteriovenous malformations may give rise to TN [18]. Trigeminal neuropathic pain also may accom-pany mixed connective tissue disorders [19], in which the pain may be steady or paroxysmal, sharp or burning, and unilateral or bilateral.…”