A Case of High-grade Arteriovenous Malformation Manifesting as Trigeminal Neuralgia Successfully Treated by Embolization in Multimodal Treatment

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Objective: The authors report a rare case of symptomatic cerebral arteriovenous malformation (AVM) manifesting as trigeminal neuralgia (TGN) that was successfully treated by a multimodal treatment.

Case Presentation: A 68-year-old man presented with right TGN. The symptom progressed with lancinating pain. Brain MRI showed a right temporal lobe AVM with a maximum diameter of approximately 50 mm. A right ectatic tortuous vertebral artery (VA) compressed the root of the right trigeminal nerve. The TGN completely disappeared after the 4th embolization. After the 6th embolization, excision was performed. No recurrence of TGN was observed in the 6 months after its excision.

Conclusion: The present case suggested that treatment of nidus may improve AVM-induced TGN. Embolization was considered to be an effective modality, especially in multimodal treatment for high-grade AVM.