Right Retrosigmoid Craniotomy for Microvascular Decompression and Glioneuronal Hamartoma Resection for Trigeminal Neuralgia: 2-Dimensional Operative Video

Oluwaseun Omoba, Samon G. Tavakoli, Justin Mascitelli

Producción científica: Articlerevisión exhaustiva

1 Cita (Scopus)

Resumen

Trigeminal neuralgia (TN) is a disabling facial pain syndrome characterized as unilateral, sharp, and lancinating in the trigeminal distribution aggravated by touching the face and chewing. First-line treatment includes anticonvulsants, with more invasive procedures indicated with failure of conservative therapy.1,2 Classical TN is caused by neurovascular contact seen on MRI or intraoperatively. Secondary TN is caused by an identifiable lesion on MRI such a tumors, arteriovenous malformations, and multiple sclerosis. Tumors can be extrinsic or intrinsic to the trigeminal nerve. Common intrinsic trigeminal nerve tumors include schwannomas, epidermoids, and lipomas.3 TN without an identifiable cause is termed idiopathic TN. We present a case of a 50-year-old man with 1 year of facial pain in the V2/3 distribution without improvement with conservative management. MRI demonstrated a prominent vascular loop compressing the right trigeminal nerve along the dorsal root entry zone without an enhancing mass. Retrosigmoid craniotomy was offered given the failure of conservative management.4 Intraoperatively, there was noted to be an expansion of neuronalappearing tissue within the trigeminal nerve or which subtotal resection was performed. Multiple vessels were dissected from the trigeminal nerve and padded with Teflon. Postoperatively, the patient denied facial pain and endorsed stable facial sensation.5 Pathologic evaluation identified the mass as a glioneuronal hamartoma. Notably, Peris-Celda et al6 showed images of a similar case with glioneuronal hamartoma. We believe our report adds to the literature by including a high-definition surgical video not included in the previous report. The patient provided informed consent for the operation depicted in this video.

Idioma originalEnglish (US)
Páginas (desde-hasta)E106
PublicaciónOperative Neurosurgery
Volumen25
N.º2
DOI
EstadoPublished - ago 24 2023

ASJC Scopus subject areas

  • General Medicine

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