title: Management of Trigeminal Neuralgia Caused by an Intraneural Spiral Trigeminocerebellar Artery: A Case Report.
abstract: The trigeminocerebellar artery (TCA) is a branch of the basilar artery that may have an intraneural course and may cause trigeminal neuralgia. We report a case of trigeminal neuralgia with right vertebral artery aneurysm caused by an intraneural TCA that compressed the trigeminal nerve in multiple places. We performed proximal trapping for the fusiform aneurysm with extra-intracranial bypass to preserve flow of the posterior inferior cerebellar artery, followed by microvascular decompression that successfully changed the course of the TCA. This procedure provided relief from the neuralgia without direct bisection of the trigeminal nerve that may cause severe nerve injury. Reshaping of the course of the artery can achieve good pain relief.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Wakuta
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Masani
authors.initials: M
authors.lastname: Nonaka
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Kochi University, Kochi, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ueba
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
keywords: intraneural vessel; reshaping; trigeminal neuralgia; trigeminocerebellar artery