Resolution of Trigeminal Neuralgia After Surgical Disconnection of a Foramen Magnum Dural Arteriovenous Fistula.

Chen, Hao; Chen, Rudong; Yang, Hongkuan; Li, Hua; Wang, Junhong; Yu, Jiasheng · World Neurosurg · 2020

case_report · Level V

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Abstract

Trigeminal neuralgia (TN) resulting from dural arteriovenous fistulas (DAVFs) is rare. TN caused by a foramen magnum DAVF has not been reported yet. We report a patient with TN caused by a foramen magnum DAVF treated with surgical disconnection. A 35-year-old man was admitted to our hospital with a right TN. Magnetic resonance imaging showed an abnormal flow void in the posterior fossa and a vascular structure next to the root entry zone of the right trigeminal nerve. Digital subtraction angiography showed a Cognard type IV DAVF located at the foramen magnum. The fistula was disconnected surgically. The patient was rendered completely pain-free, and the fistula did not recur during 4-year follow-up. DAVF is a rare cause of TN. Surgical disconnection is an effective treatment method for TN caused by a foramen magnum DAVF.

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