Thomas Robert1, Raphaël Blanc2, Gabriele Ciccio2, Stanislas Smajda2, Hocine Redjem2, Robert Fahed2, Michel Piotin2. 1. Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France. Electronic address: thomas.robert43@gmail.com. 2. Department of Interventional Neuroradiology, Rothschild Foundation Hospital, 25 Rue Manin, Paris 75019, France.
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.
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: Bartosz Szmyd; Julia Sołek; Maciej Błaszczyk; Jakub Jankowski; Paweł P Liberski; Dariusz J Jaskólski; Grzegorz Wysiadecki; Filip F Karuga; Agata Gabryelska; Marcin Sochal; R Shane Tubbs; Maciej Radek Journal: Front Mol Neurosci Date: 2022-07-04 Impact factor: 6.261