Neurovascular compression associated with trigeminal neuralgia and systemic arterial hypertension: surgical treatment.
OBJECTIVE
To highlight arterial hypertension as an additional factor favoring surgical indication in neurovascular compression syndromes such as trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia.


METHODS
A 52-year-old woman with trigeminal neuralgia concomitant with systemic arterial hypertension, submitted initially to unsatisfactory conservative treatment, presents tortuousness and enlargement of the vertebral artery (VA) topography on magnetic resonance imaging (MRI). A microsurgical neurovascular decompression of the trigeminal nerve and the medulla was performed, revealing that the compression was due to the superior cerebellar artery instead of the VA. Both the neuralgia and the hypertension were controlled with no need of medication during a 1-year follow-up.


CONCLUSIONS
Surgical indication in neurovascular compression disorders should be reinforced in the presence of concomitant arterial hypertension and a compatible MRI examination.
Sendeski
Mauricio
M
Clínica Neurocirúrgica Pinheiros, São Paulo, Brazil.
Aguiar
Paulo Henrique
PH
Zanetti
Marcus Vinicius
MV
Teixeira
Manoel Jacobsen
MJ
Cescato
Valter Angelo
VA
D002531:Cerebellum / Q000098:blood supply; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D011311:Pressoreceptors / Q000502:physiology; D017552:Solitary Nucleus / Q000502:physiology; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D014711:Vertebral Artery / Q000473:pathology