A Rare Cause of Trigeminal Neuralgia: Cerebellopontine Angle Meningioma

Abstract

Trigeminal neuralgia (TN) is a neuropathic pain described as intense and electric shock-like pain episodes in the trigeminal nerve territory. Most of the time, trigeminal neuralgia is called as idiopathic TN since the cause is not known. Sometimes, space occupying lesions such as meningiomas, trigeminal neuromas and aneurysms may trigger TN. Cerebellopontine angle’s tumors are 6-10% of all intracranial tumors (1). Epidermoid cyst is the most common cause of TN and meningiomas and neurinomas can also cause TN (2). These tumors can cause trigeminal neuralgia in 3 ways; aThe tumor presses on the nerve directly, bThe tumor compresses the nerve root by pushing arterial vessels, cCompression of tumor to pons can cause irritation of the trigeminal nerve nuclei (2). The tumors which are causing TN have different Magnetic resonance imaging (MRI) characteristics. For instance, epidermoids usually do not compression to adjacent structures, no enhancement and bright on DWI. Schwannomas expand the nerve and extend into the internal auditory canal. Meningiomas have dural tail, generally strong and homogeneous contrast enhancement (3).