title: Decision-making in classic trigeminal neuralgia concurrent with a pontine cavernous malformation: Causal or coincidental association?
abstract: Trigeminal neuralgia is classically associated with neurovascular compression of the trigeminal nerve, at the root entry zone (REZ). However, patients are occasionally affected by intra-axial involvement of trigeminal sensory fibers caused by demyelinating diseases, strokes and, rarely, pontine cavernous malformations. We discuss the management strategies and decision-making process in a 55-year-old patient, affected by trigeminal neuralgia with 2 potential causative mechanisms: a neurovascular conflict at the trigeminal REZ and an ipsilateral cavernous malformation at the pontine nucleus of the trigeminal nerve.
authors.affiliation: Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Surgical Specialties, Division of Neurosurgery, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: parise@infolink.com.br.
authors.forename: Maud
authors.initials: M
authors.lastname: Parise
authors.affiliation: Department of Surgical Specialties, Division of Neurosurgery, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Marcus André
authors.initials: MA
authors.lastname: Acioly
authors.affiliation: Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Neurology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Maurice
authors.initials: M
authors.lastname: Vincent
authors.affiliation: Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Emerson Leandro
authors.initials: EL
authors.lastname: Gasparetto
mesh_terms: D000066491:Clinical Decision-Making; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000002:abnormalities*; D014277:Trigeminal Neuralgia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
keywords: Brainstem cavernous malformation; Compresión neurovascular; Malformación cavernosa del tronco cerebral; Neuralgia del trigémino; Neurovascular compression; Trigeminal neuralgia