Resolution of Trigeminal Neuralgia After Surgical Disconnection of a Foramen Magnum Dural Arteriovenous Fistula

World Neurosurg. 2020 Mar:135:209-213. doi: 10.1016/j.wneu.2019.07.063. Epub 2019 Jul 12.

Abstract

Background: Trigeminal neuralgia (TN) resulting from dural arteriovenous fistulas (DAVFs) is rare. TN caused by a foramen magnum DAVF has not been reported yet. We report a patient with TN caused by a foramen magnum DAVF treated with surgical disconnection.

Case description: A 35-year-old man was admitted to our hospital with a right TN. Magnetic resonance imaging showed an abnormal flow void in the posterior fossa and a vascular structure next to the root entry zone of the right trigeminal nerve. Digital subtraction angiography showed a Cognard type IV DAVF located at the foramen magnum. The fistula was disconnected surgically. The patient was rendered completely pain-free, and the fistula did not recur during 4-year follow-up.

Conclusions: DAVF is a rare cause of TN. Surgical disconnection is an effective treatment method for TN caused by a foramen magnum DAVF.

Keywords: Dural arteriovenous fistula; Foramen magnum; Surgical disconnection; Trigeminal neuralgia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiography, Digital Subtraction
  • Arteriovenous Fistula / complications*
  • Arteriovenous Fistula / surgery
  • Central Nervous System Vascular Malformations / complications*
  • Central Nervous System Vascular Malformations / surgery
  • Cerebral Angiography
  • Computed Tomography Angiography
  • Foramen Magnum*
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Male
  • Nerve Compression Syndromes / etiology
  • Neurosurgical Procedures
  • Trigeminal Neuralgia / etiology*