Trigeminal neuralgia - vascular compression

Case contributed by Mostafa Elfeky
Diagnosis almost certain


Dizziness, long history of right trigeminal neuralgia on treatment.

Patient Data

Age: 55 years
Gender: Female

Posterior fossa


The right superior cerebellar artery is contacting the medial surface of the right trigeminal nerve.

Preserved girth and signal intensity of both trigeminal nerves.

Case Discussion

The patient is on medical treatment of trigeminal neuralgia for four years. The presence of vascular indentation of the nerve supported by a clinical presentation and involvement of ipsilateral side and no other pathologies affecting the course of the right trigeminal nerve makes the possibility of the trigeminal neuralgia due to vascular compression primarily considered.

In this case, the compression of the right trigeminal nerve by loops of the right superior cerebellar artery. Anterior inferior cerebellar artery also reported being a possible cause of vascular compression of the trigeminal nerve. 

The transitional zone between central and peripheral myelin is the most vulnerable region for symptomatic neurovascular compression.  

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