Radiation induced vascular injury after stereotactic radiosurgery for trigeminal neuralgia: case report.
BACKGROUND
Stereotactic radiosurgery is increasingly used for the treatment of medically unresponsive trigeminal neuralgia.


METHODS
We present the case of a 69-year-old man with trigeminal neuralgia who underwent stereotactic radiosurgery after a failed balloon compression procedure. The radiosurgery also failed to provide the patient with any significant pain relief, and microvascular decompression of the trigeminal nerve was performed 10 months later. At operation, two adjacent veins and the superior cerebellar artery were noted to have focal changes consistent with atheromatous disease.


CONCLUSIONS
We postulate that the recent radiation exposure resulted in the observed vascular injury. As a result, patients having trigeminal neuralgia radiosurgery need to be followed carefully for possible delayed ischemic events secondary to radiation-induced vascular injury.
Maher
C O
CO
Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Pollock
B E
BE
D000368:Aged; D002531:Cerebellum / Q000098:blood supply*; D019299:Decompression, Surgical; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000209:etiology*; D008297:Male; D008866:Microsurgery; D011183:Postoperative Complications / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology*; D016634:Radiosurgery; D012086:Reoperation; D014277:Trigeminal Neuralgia / Q000601:surgery*; D014680:Veins / Q000528:radiation effects