A Case of Classical Trigeminal Neuralgia Associated with Bilateral Agenesis of the Internal Carotid Arteries

• DOI: 10.5466/ijoms.14.91
• Publication Date: 2016-03-29T22:51:05Z
• Authors: Hideta Nishimori; Yasuhide Makiyama; Takashi Iida; Hirona Kamiyama; Takashi Uchida; Hitoshi Nishimura; Masakazu Okubo; Michiharu Shimosaka; Noriyuki Narita; Hitoshi Hirota; Hideo Niwa; Osamu Komiyama; Misao Kawara
• Keywords: Magnetic resonance angiography; Agenesis; Anterior cerebral artery

We describe a case of trigeminal neuralgia caused by compensatory enlargement the basilar artery in patient with bilateral agenesis internal carotid arteries. A 46-year-old man experienced sharp, stabbing pain left face when washing his face. In imaging examinations, magnetic resonance imaging(MRI)revealed displacement nerve due to and leftward deviation, but no brain tumors or other abnormalities. The was not visible on angiography(MRA), marked vertebral arteries seen, along considerable deviation artery. anterior middle cerebral constituting circulation were bilaterally connected posterior communicating artery, which enlarged. Bilateral vestigially interrupted from bifurcation common No canals apparent either side computed tomography(CT). For symptoms, we managed using carbamazepine, instructed follow low-salt, low-fat diet avoid excessive alcohol consumption. Our report suggest that examination(e.g. CT, MRA MRI)are essential investigating neuralgia, order visualize head neck region identify any causal vessels confirm presence absence tumors. addition, patients abnormal hemodynamic status such as an megadolichobasilar anomaly should undergo regular follow-up high risk hemorrhage infarction.