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

Miyahito Kugai; Takehiro Suyama; Masahiko Kitano; Hiroshi Hasegawa; Yoshiko Tominaga; Shinsuke Tominaga

doi:10.5797/jnet.cr.2019-0005

This article has now been updated. Please use the final version.

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

Miyahito Kugai, Takehiro Suyama, Masahiko Kitano, Hiroshi Hasegawa, Yoshiko Tominaga, Shinsuke Tominaga

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Keywords: trigeminal neuralgia, vertebral artery, arteriovenous malformation, embolization, multimodal treatment

JOURNAL OPEN ACCESS Advance online publication

Article ID: cr.2019-0005

DOI https://doi.org/10.5797/jnet.cr.2019-0005

The final version of this article is now available: Vol. 13 (2019), No. 9 pp. 382-387

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Abstract

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.

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