title: Suprameatal extension of retrosigmoid approach for microvascular decompression of trigeminal nerve: Case report.
abstract: BACKGROUND
  Trigeminal neuralgia is produced in a significant number of cases by vascular compression at the level of cisternal segment of the nerve at the entry of the pons. It is common to find superior cerebellar artery (SCA) responsible for this compression. The retrosigmoid approach (RA), with asterional craniectomy, clearly exposes the cisternal portion of the trigeminal nerve (TN).
  
  
  METHODS
  We describe in this case report how vessels at the trigeminal pore level known as "Meckel's segment" can compress the TN. This situation is unusual. One of the reasons why the compression of this Meckel's segment level could be overlooked is a suprameatal tubercle (ST) prominence that would prevent trigeminal pore visualization through retrosigmoid approach.
  
  
  CONCLUSIONS
  The suprameatal extension of this approach has been described for other purposes, especially in tumors invading Meckel's cave resection. We could not find publications for the use of the resection of the suprameatal tubercle in the retrosigmoid approach for microvascular decompression of the trigeminal neuralgia.
  
  
  CONCLUSIONS
  Microvascular decompression of the TN is an effective treatment for trigeminal neuralgia, however in some cases, in which vascular compression is not evident when exploring the cerebellopontine angle, it is important to note that association of a prominent ST can hide a vascular compression of the nerve in this region.
authors: Neurosurgery Service, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico.
authors: Juan Carlos
authors: JC
authors: Moreira-Holguin
authors: Neurosurgery Service, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico.
authors: Rogelio
authors: R
authors: Revuelta-Gutierrez
authors: Neurosurgery Service, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico.
authors: Alejandro
authors: A
authors: Monroy-Sosa
authors: Neurosurgery Service, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico.
authors: Samuel
authors: S
authors: Almeida-Navarro
keywords: Retrosigmoid approach; Suprameatal extension; Trigeminal neuralgia