title: Trigeminal neuralgia caused by an anomalous posterior inferior cerebellar artery from the primitive trigeminal artery: case report.
abstract: A 61-year-old woman presented with typical trigeminal neuralgia (TN), caused by an aberrant posterior inferior cerebellar artery (PICA) associated with the primitive trigeminal artery (PTA). Magnetic resonance angiography and digital subtraction angiography clearly showed an anomalous artery directly originating from the PTA and coursing into the PICA territory at the cerebellum. During microvascular decompression (MVD), we confirmed and decompressed vascular compression of the trigeminal nerve by this anomalous, PICA-variant type of PTA. The PTA did not conflict with the trigeminal nerve, and the anomalous PICA only compressed the caudolateral part of the trigeminal nerve, without the more common compression at its root entry zone. This case is informative due not only to its very unusual angioanatomical variation but also to its helpfulness for surgeons preparing a MVD for a TN associated with such a rare vascular anomaly.
authors.affiliation: Stroke and Neurological Disorders Centre, East-West Neo Medical Hospital of Kyung Hee University, Seoul, South Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Koh
authors.forename: Cheol Young
authors.initials: CY
authors.lastname: Lee
mesh_terms: D000329:Advertising; D015901:Angiography, Digital Subtraction; D001158:Arteries / Q000002:abnormalities*; D002531:Cerebellum / Q000002:abnormalities / Q000098:blood supply; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000601:surgery