Rare case of trigeminal neuralgia due to vascular compression presenting with severe headache – A case report

Trigeminal
neuralgia (TN), formerly called tic douloureux, is among the most severe physical and
psychological illnesses a person can experience. People with Trigeminal neuralgia considerably
negatively influence their excellence in life, resulting in various issues such as weight
reduction and despair. Neurovascular conflict is the etiology of Trigeminal
neuralgia.

Trigeminal
neuralgia causes a sudden, excruciating facial pain that primarily affects the
lower cheek and jaw, and the
region surrounding the nostril and above the eyes is affected.

This is an
interesting case report from Department of General Medicine, IMS and SUMH,
Bhubaneswar, Odisha, India, where a successful neurosurgery actually helped a patient to get
rid of recurring headaches, where previously treating physicians were treating the
patient for migraine. But the patient was suffering from vascular compression of a
neurological condition called trigeminal neuralgia.

In this case, a
55-year-old elderly female with a migraine background appeared with a severe headache
and terrible intermittent ache on the left part of her face for the previous 3 weeks.
Migraine medicines and over-the-counter analgesics did not ease the agony. Her
neurological test revealed that her motor, sensory, and cranial nerve examinations were
standard, with no indication of facial deformity or muscle weakness.

The presence of
direct contact between the superior cerebellar artery and the trigeminal
nerve on the left side was verified by a contrast MRI, which yielded a tentative
diagnosis of Trigeminal neuralgia. The patient was advised to undergo
neurosurgical therapy precisely
microvascular decompression.

The optimal
surgical technique in this instance was microvascular decompression, because a
neurovascular issue was apparent during the Imaging, and the patient was deemed
healthy enough to perform open neurosurgery.

The patient’s
symptoms disappeared without problems after surgery, and there were no neuralgic
episodes at the 6-month and 1-year follow-up visits.

Reference:

Vihari
J, Sriteja N, Swain B, Krishna AV, Aditya A, Aneesh KV. Rare case of trigeminal
neuralgia due to vascular compression presenting with severe headache – A case
report. Med India 2022;1:13.

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