title: Trigeminal neuralgia due to arterialization of the superior petrosal vein in the context of dural or cerebral arteriovenous shunt.
abstract: OBJECTIVE
  Trigeminal neuralgia (TN) is a rare revealing symptom of dural or cerebral arteriovenous (AV) shunt. Few isolated cases have described the association between TN and arteriovenous shunt. We presented our experience concerning cerebral AV shunt revealed by a TN.
  
  
  METHODS
  Between 2003 and 2013, 548 brain AV malformations (bAVM) and 268 dural AV fistulas (dAVF) were treated and a retrospective analysis identified 10 consecutive cases with TN. We reviewed their clinical and angiographic data and as well as their outcome after endovascular treatment.
  
  
  RESULTS
  Among the 10 patients, 5 presented a bAVM and 5 a dAVF. TN was contralateral to the AV shunt in 2 cases (20%). The superior petrosal vein (SPV) was arterialized in all cases. An ectasia of the SPV which could explain a compression of the trigeminal nerve was found in two cases only (20%). It seems that a venous hyperpressure in the ponto-trigeminal vein (tributary of the SPV) is responsible of the TN, rather than a compressive mechanism.
  
  
  CONCLUSIONS
  Contrary to other publications on this topic, we believe that the venous reflux into tributaries of the superior petrous vein (and in particular the ponto-trigeminal vein) seems to be the first mechanism of the TN rather that the nerve compression.
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France. Electronic address: thomas.robert43@gmail.com.
authors: Thomas
authors: T
authors: Robert
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
authors: Raphaël
authors: R
authors: Blanc
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
authors: Gabriele
authors: G
authors: Ciccio
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
authors: Stanislas
authors: S
authors: Smajda
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
authors: Hocine
authors: H
authors: Redjem
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
authors: Robert
authors: R
authors: Fahed
authors: Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
authors: Michel
authors: M
authors: Piotin
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014276:Trigeminal Nerve / Q000473:pathology; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000209:etiology
keywords: Arteriovenous malformation; Dural arteriovenous fistula; Superior petrous vein; Trigeminal neuralgia