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Anesthesia-induced Takotsubo cardiomyopathy in trigeminal neuralgia: illustrative case

Guido Mazzaglia, Giulio Bonomo, Emanuele Rubiu, Paolo Murabito, Alessia Amato, Paolo Ferroli, and Marco Gemma

, trigeminal neuralgia is linked with sudden pain and prolonged suffering that may provoke a physical and psychological stress response. In this paper, we present a case of TS that manifested during induction of anesthesia to perform a surgical microvascular decompression (MVD) of the left trigeminal nerve in a patient with trigeminal neuralgia. We expose the peculiar clinical picture and discuss the possible underlying pathophysiological mechanisms. Illustrative Case We present a case of a 50-year-old female patient scheduled for an MVD who presented immediately

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Trigeminal neuralgia induced by brainstem infarction treated with pontine descending tractotomy: illustrative case

Rachyl M. Shanker, Miri Kim, Chloe Verducci, Elhaum G. Rezaii, Kerry Steed, Atul K. Mallik, and Douglas E. Anderson

Trigeminal neuralgia (TN) most commonly presents as neuropathic pain secondary to neurovascular compression (NVC) at the nerve root entry zone (NREZ) 1 , 2 or as a result of a space-occupying lesion impacting the trigeminal nerve. 3 However, there exists a subset of patients in whom trigeminal pain is induced by brainstem ischemia, interrupting the NREZ, spinal trigeminal nucleus, or descending spinal trigeminal tract (SpTV). While cases of TN induced by a brainstem infarct have been reported, there are no clear treatment recommendations for this

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Simultaneous microvascular decompression for trigeminal neuralgia and hemifacial spasm involving a dolichoectatic vertebral artery in an elderly patient: illustrative case

Neelan J. Marianayagam, Hanya M. Qureshi, Sagar Vasandani, Shaurey Vetsa, Muhammad Jalal, Kun Wu, and Jennifer Moliterno

Trigeminal neuralgia (TN) and hemifacial spasm (HFS) refractory to medical management can commonly be the result of direct contact by an aberrant vessel compressing the root entry zone (REZ) of the trigeminal and facial nerves, respectively. Microvascular decompression (MVD) has been shown to provide lasting relief. 1 In TN, the offending vessel is usually the superior cerebellar artery, whereas in HFS, it is usually the anterior inferior cerebellar artery. There are instances, however, in which an enlarged or dolichoectatic vertebral artery (DVA) can be the

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Arteriovenous malformation of the trigeminal nerve root presented with venous congestive edema of the medulla oblongata and upper cervical cord: illustrative case

Arata Nagai, Hidenori Endo, Kenichi Sato, Tomohiro Kawaguchi, Hiroki Uchida, Shunsuke Omodaka, Yasushi Matsumoto, and Teiji Tominaga

layer of the TNR, which was fed by the PPA and the AICA and originally provided arterial supply for the TNR. 9 The present case’s angioarchitecture was similar to that of the AVM in the cerebellopontine angle cistern (CPAC). 10 Among the CPAC AVMs, a total of 34 cases were associated with the TNR ( Table 1 ). 2–8 , 10–18 TNR AVM occurs predominantly among early-middle– to late-middle–aged males, often presenting with hemorrhage or trigeminal neuralgia. This is the first case that presented as TNR AVM with brainstem edema. The main draining routes are usually

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Middle meningeal artery pseudoaneurysm and pterygoid plexus fistula following percutaneous radiofrequency rhizotomy: illustrative case

Rahim Ismail, Derrek Schartz, Timothy Hoang, and Alexander Kessler

The percutaneous approach to the trigeminal nerve via the foramen ovale originated in the early 20th century from Taptas and Hartel in 1911 and 1913, 1 respectively, with electrocoagulation developed by Rethi in 1913. 2 Over the subsequent century, much advancement in the percutaneous techniques has occurred including chemodenervation, radiofrequency ablation, cryoablation, nerve blocks, Botox injections, nerve stimulation, and balloon decompression. 2 Percutaneous treatment for trigeminal neuralgia is generally considered a well-tolerated procedure, with

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Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case

Leonie Witters, Anton Lukes, and Tomas Menovsky

. 1968 ; 29 ( 6 ): 609 – 618 . 10.3171/jns.1968.29.6.0609 9233495 3. Guinto G , Guinto Y . Nervus intermedius . World Neurosurg . 2013 ; 79 ( 5-6 ): 653 – 654 . 10.1016/j.wneu.2012.05.011 11440431 4. Hunt J . Geniculate neuralgia (neuralgia of the nervus facialis): a further contribution to the sensory system of the facial nerve and its neuralgic conditions . Arch Neurol Psychiatry . 1937 ; 37 ( 2 ): 253 – 285 . 10.1001/archneurpsyc.1937.02260140039003 3771298 5. Love S , Coakham HB . Trigeminal neuralgia: pathology and

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Endovascular treatment of a ruptured aneurysm arising from the proximal end of a partial vertebrobasilar duplication with a contralateral prominent persistent primitive hypoglossal artery: illustrative case

Nobuyuki Genkai, Kouichirou Okamoto, Toshiharu Nomura, and Hiroshi Abe

, Tomsick TA , Wallace RC . The persistent fetal carotid-vertebrobasilar anastomoses . AJR Am J Roentgenol . 1999 ; 172 ( 5 ): 1427 – 1432 . 10.2214/ajr.172.5.10227532 7. Marinković S , Gibo H , Nikodijević I . Trigeminocerebellar artery—anatomy and possible clinical significance . Neurol Med Chir (Tokyo) . 1996 ; 36 ( 4 ): 215 – 219 . 10.2176/nmc.36.215 8. Amagasaki K , Abe S , Watanabe S , Trigeminal neuralgia caused by a trigeminocerebellar artery . J Neurosurg . 2014 ; 121 ( 4 ): 940 – 943 . 10.3171/2014.6.JNS132292

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Computational hemodynamic analysis of the offending vertebral artery at the site of neurovascular contact in a case of hemifacial spasm associated with subclavian steal syndrome: illustrative case

Keita Tominaga, Hidenori Endo, Shin-ichiro Sugiyama, Shin-ichiro Osawa, Kuniyasu Niizuma, and Teiji Tominaga

Neurovascular compression syndromes such as hemifacial spasm (HFS) and trigeminal neuralgia (TN) are generally caused by neurovascular contact between the vascular structure and the cranial nerves. In HFS, neurovascular compression occurs along the root exit zone (REZ) of the facial nerve, most commonly by either the anterior inferior cerebellar artery or the posterior inferior cerebellar artery (PICA) and rarely by vertebral artery (VA). Microvascular decompression (MVD) is an effective microsurgical treatment option for HFS through releasing the contact of

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Percutaneous transluminal angioplasty for persistent primitive hypoglossal artery stenosis: illustrative case

Katsuma Iwaki, Koichi Arimura, Shunichi Fukuda, Soh Takagishi, Ryota Kurogi, Kuniyuki Nakamura, Akira Nakamizo, and Koji Yoshimoto

accompanied by PPHA or PPHA stenosis have been treated surgically and endovascularly; however, we did not find reports regarding endovascular treatment for progressive stenosis of the PPHA. 3 , 4 Here, we describe for the first time a case of symptomatic and progressive stenosis of a PPHA that was treated using percutaneous transluminal angioplasty (PTA). Illustrative Case History and Examination A 68-year-old male with trigeminal neuralgia was referred to our hospital. The patient and his family had no history of cerebrovascular diseases, and he was not

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Microvascular decompression for developmental venous anomaly causing hemifacial spasm: illustrative case

Margaret Tugend and Raymond F Sekula Jr.

DVA or a decrease in outflow from the DVA. Symptoms from flow-related causes include headache, neurological deficit, seizures, and coma secondary to hemorrhage or infarction. Mechanical causes include obstructive hydrocephalus and nerve compression, causing trigeminal neuralgia and HFS. Cases with symptoms attributed to DVA, such as headache, but with no identifiable patho-mechanism, are classified as idiopathic. 5 Here, we present an example of mechanical compression of the facial nerve by a pontine DVA ostensibly causing HFS. Although the patient ultimately had a