Turkish Neurosurgery 2014 , Vol 24 , Num 1
Typical Trigeminal Neuralgia by an Atypical Compression: Case Report and Review of the Literature
Giovanni GRASSO1, Marcello PASSALACQUA2, Filippo GIAMBARTINO1, Fabio CACCIOLA2, Gerardo CARUSO2, Francesco TOMASELLO2
1University of Palermo, Department of Experimental Biomedicine and Clinical Neurosciences, Neurosurgical Clinic, Palermo, Italy
2University of Messina, Department of Neurosurgery, Neurosurgical Clinic, Messina, Italy
DOI : 10.5137/1019-5149.JTN.7048-12.0 AIM: Trigeminal neuralgia is a disabling form of facial pain that causes a considerable discomfort and a marked reduction in the quality of life. Although neurovascular compression is often associated with trigeminal neuralgia, other intracranial pathologies can result in compression along the nerve.

CASE DESCRIPTION: The authors report a case of a patient suffering from a typical left trigeminal neuralgia affecting both the second and the third branches. Neuroradiological examinations showed the presence of an arachnoid cyst located in the left temporal lobe, contiguous with the Meckel’s cave, eroding the greater wing of the sphenoid bone. Following a meticulous decision-making process the patient underwent conservative treatment with success. A properly modulation of the drug dosage allowed pain relief to be achieved.

CONCLUSION: This is a rare case reporting a typical trigeminal neuralgia by an arachnoid cyst of the Meckel’s cave mimicking a neurovascular compression syndrome. Our findings, behind the review of the current literature, point out the importance of such a pathological condition when dealing with patients affected by cranial nerve dysfunction syndrome. Keywords : Arachnoid cyst, Trigeminal neuralgia, Conservative treatment

Corresponding author : Giovanni Grasso, giovanni.grasso@unipa.it