Electrical neurocoagulation may be effective for intractable trigeminal neuralgia caused by vertebrobasilar dolichoectasia

Abstract

In most cases of trigeminal neuralgia, vascular compression is caused by the superior cerebellar artery (SCA) or anterior inferior cerebellar artery. Compression of the vertebral artery (VA) or basilar artery (BA) is rarely reported, accounting for approximately 2 % [13]. Surgical treatment of trigeminal neuralgia was firstly proposed by Jannetta et al. [9], and microvascular decompression via a suboccipital approach is the most frequently used procedure. However, it may be difficult to perform this procedure when an elongated VA or BA compresses the trigeminal nerve. This report documents a case in which severe trigeminal neuralgia caused by vertebrobasilar dolichoectasia (VBD) was successfully treated by electrical neurocoagulation (ENC) of a depressed nerve. This surgical procedure could be one of the options when transposition of responsible vessel is technically or anatomically difficult. Case report