title: Trigeminal neuralgia in a patient with Marfan syndrome: case report.
abstract: Marfan syndrome can demonstrate tortuous and elongated intracranial arteries. However, these arteries rarely cause neurovascular compression resulting in hemifacial spasm or trigeminal neuralgia. The authors report a 33-year-old woman who was diagnosed as Marfan syndrome, suffered from trigeminal neuralgia. Magnetic resonance (MR) angiography showed tortuous and elongated left vertebral artery (VA). The coronal section of three dimensional (3D) MR cisternography with contrast enhancement showed that the left trigeminal nerve was compressed from underneath by the tortuous and elongated left VA. After successful surgery of microvascular decompression, the patient's symptom resolved and no recurrence was encountered. Neurosurgeons should not only be aware of hemifacial spasm but also of trigeminal neuralgia caused by elongated vessels in a patient with Marfan syndrome, although it is an extremely rare condition. In addition, offending vessel is not atherosclerotic in younger patients unlike usual cases of trigeminal neuralgia. Thus, microvascular decompression can be easier than usual cases. Care should be taken to prevent arterial dissection during transposition by using some technical tips.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University of Tsukuba.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sakakura
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Akutsu
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Masuda
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ishikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications*; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000601:surgery*