Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Case Report Volume 6 Issue 6

Surgical Management for Trigeminal Neuralgia Caused by Trigeminocerebellar Artery Compression

Keisuke Onoda*, Yoshifumi Ogasawara, Ren Fujiwara, Takahiro Kumono, Yu Hirokawa, Tomihiro Wakamiya, Yuhei Michiwaki, Tatsuya Tanaka, Takashi Agari, Kazuaki Shimoji, Eiichi Suehiro, Hiroshi Itokawa, Fumitaka Yamane and Akira Matsuno

Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Japan

*Corresponding Author: Keisuke Onoda, Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Japan.

Received: April 20, 2023; Published: May 28, 2023


The trigeminocerebellar artery (TCA) originates from the basilar artery and perfuses the trigeminal nerve root and cerebellar hemisphere. In this case report, we identified a TCA compressing the trigeminal nerve in a 65-year-old woman with left trigeminal neuralgia (TN). We discuss the surgical approach to achieve excellent results. A 65-year-old woman was referred to our department due to experiencing paroxysmal electric pain in the left mandibular area, which was triggered by eating. She was initially treated medically by a family doctor, although the effectiveness of the treatment decreased over time. The patient was diagnosed with TN and underwent left microvascular decompression surgery. During the surgical procedure, it was observed that the left superior cerebellar artery (SCA) was in contact with the trigeminal nerve from the cranial side and that the TCA formed a loop that severely compressed the trigeminal nerve and ran between the sensory and motor branches. The SCA was moved to the cerebellar tentorial side and fixed, and the TCA was dissected from the trigeminal nerve, pulled out, and repositioned such that the loop would not press on the nerve. Following the surgery, the patient’s left TN disappeared immediately, and she was discharged from the hospital one week later without any neurological deficits. In conclusion, to avoid complications, it is essential to manage the vessels that penetrate the trigeminal nerve with care. One effective and safe surgical procedure involves decompressing the trigeminal nerve by removing the responsible artery and altering its trajectory.

Keywords: Trigeminocerebellar Artery; Trigeminal Neuralgia; Microvascular Decompression; Intraneural Compression


  1. Jannetta PJ., et al. “Treatment of trigeminal neuralgia”. Neurosurgery 4 (1979): 93-94.
  2. Patel SK., et al. “The historical evolution of microvascular decompression for trigeminal neuralgia: from Dandy's discovery to Jannetta's legacy”. Acta Neurochirurgica (Wien) 162 (2020): 2773-2782.
  3. Jannetta PJ. “A comprehensive reference guide to the diagnosis and management of neurological problems. Cranial rhizopathies”. In: Youmans JR, ed. Neurological Surgery. Philadelphia, PA: WB Saunders (1990): 4169-4182.
  4. Marinković S., et al. “Trigeminocerebellar artery--anatomy and possible clinical significance”. Neurologia Medico-chirurgica (Tokyo) 36 (1996): 215-219.
  5. Tuccar E., et al. “Anatomy and clinical significance of the trigeminocerebellar artery”. Journal of Clinical Neuroscience 16 (2009): 679-682.
  6. Stephens RB., et al. “Arteries and Veins of the Human Brain”. Springfield, Ill: CC Thomas (1969): 71-123.
  7. Helbig GM., et al. “Variant intraneural vein trigeminal nerve relationships: an observation during microvascular decompression surgery for trigeminal neuralgia”. Neurosurgery 65 (2009): 958-996.
  8. Jito J., et al. “Trigeminal Neuralgia Attributable to Intraneural Trigeminocerebellar Artery: Case Report and Review of the Literature”. World Neurosurgery 88 (2016): 687.e7-687.e11.
  9. Zheng X., et al. “Management of intraneural vessels during microvascular decompression surgery for trigeminal neuralgia”. World Neurosurgery 77 (2012): 5-6.
  10. Ichimasu N., et al. “Microvascular decompression for trigeminal neuralgia caused by trigeminocerebellar artery”. Neurosurgery Focus VIDEO 3 (2020): V4.
  11. Wakuta N., et al. “Management of trigeminal neuralgia caused by an intraneural spiral trigeminocerebellar artery: a case report”. Journal of Neurological Surgery Reports 76 (2015): e59-e61.


Citation: Keisuke Onoda., et al. “Surgical Management for Trigeminal Neuralgia Caused by Trigeminocerebellar Artery Compression". Acta Scientific Neurology 6.6 (2023): 42-45.


Copyright: © 2023 Keisuke Onoda., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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