Cerebellopontine angle cysticercus and concurrent vascular compression in a case of trigeminal neuralgia.
The authors present the case of a 59-year-old woman with an 8 months history of lancinating pain and hyphestesia on the right side of the face along with hearing impairment. She had poor tolerance to carbamazepine. A non-enhancing cystic image was observed at the right cerebellopontine angle on magnetic resonance imaging. The patient underwent surgery. Through a right retromastoid minicraniectomy and under microscopic magnification the VII and VIII cranial nerve complex was found involved by multiple adhesions around a cysticercus. After the cyst was removed a loop of the anteroinferior cerebellar artery was identified compressing the V right nerve at its root entry zone. Decompression was performed by the insertion of a Teflon implant. The postoperative course was uneventful and trigeminal neuralgia (TN) disappeared after surgery. Five previous cases of cranial nerve hyperactive dysfunction syndromes, four of trigeminal neuralgia and one of hemifacial spasm associated to cerebellopontine angle cysticercosis are briefly commented. We suggest that in some of these cases microvascular compression was probably present, and during surgery of cerebellopontine angle cysticercus by either trigeminal neuralgia or hemifacial spasm, vascular compression must be carefully searched and treated when found.
Revuelta
Rogelio
R
Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Insurgentes Sur 3877, Tlalpan, C.P. 14269 México, DF, Mexico. rogelio_revuelta@hotmail.com
Soto-Hernández
José Luis
JL
Vales
Lourdes Olivia
LO
González
Ramón Hinojoza
RH
D001158:Arteries / Q000601:surgery; D002526:Cerebellar Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D002530:Cerebellopontine Angle / Q000098:blood supply / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply*; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D011843:Radiculopathy / Q000175:diagnosis* / Q000601:surgery; D000267:Tissue Adhesions / Q000601:surgery; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis* / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000601:surgery