Microvascular sling decompression for trigeminal neuralgia secondary to ectatic vertebrobasilar compression

Case report

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✓ A patient with trigeminal neuralgia caused by a tortuous and ectatic vertebrobasilar artery is presented. He was treated with microvascular decompression using a fine silicone sling sutured to the dura over the petrous pyramid. The technical details are described.

Article Information

Address for Dr. Crowell: Neurosurgical Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Address reprint requests to: James L. Stone, M.D., Division of Neurosurgery, Cook County Hospital, Loyola University Medical School, 1835 West Harrison Street, Chicago, Illinois 60612.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Magnetic resonance T2-weighted image demonstrating tortuous vascular loops (arrow) in the left pontocerebellar region of the left trigeminal nerve complex.

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    Left vertebral angiogram, anteroposterior view, showing extreme looping of the large vertebrobasilar artery complex toward the left pontocerebellar region (arrow).

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    Intraoperative drawing of the left cerebellopontine angle. The large vertebrobasilar artery complex indented and displaced the superior root entry of the trigeminal nerve (5) (arrow indicates the point of contact). Ret = retractor blade over the cerebellum; tent = tentorium cerebelli; s = silicone sling retracting the vertebrobasilar artery complex; the facial and acoustic nerves are denoted by “7” and “8,” respectively.

References

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