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.