Abstract
A clinical diagnosis of typical trigeminal neuralgia does not rule out the possibility of a space-occupying lesion compressing the nerve along its course from the brainstem to Meckel's cave. 4 cases of typical trigeminal neuralgia, treated medically for several years and seen here recently before a space-occupying lesion was found in the posterior cranial fossa, point up the need for thorough neurological and neuroradiological examination of all patients with the typical symptoms. Lesion removal resulted in total relief from pain in 3 patients. In the fourth patient the pain was controlled by percutaneous surgery with thermocoagulation of the gasserian ganglion.
Sommario
La diagnosi clinica di nevralgia trigeminale tipica non esclude la possibilità della persenza di una lesione espansiva comprimente il nervo lungo il suo decorso dal tronco encefalico al cavo di Meckel. La recente osservazione di quattro pazienti con nevralgia trigeminale tipica, trattati per vari anni con terapia medica, prima che fosse rivelata la presenza di un processo espansivo in fossa cranica posteriore ci offre l'occasione di sottolineare la necessità di sottoporre tutti i pazienti con tale sintomatologia ad un esame neurologico e neuroradiologico accurato.
La rimozione del processo espansivo ha determinato la completa scomparsa del quadro doloroso in tre pazienti, mentre nel quarto caso la nevralgia è stata controllata con un intervento chirurgico percutaneo di termocoagulazione del ganglio di Gasser.
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References
Borne G.:Trigeminal neuralgia as the presenting symptom of a tuberculoma of the cerebellopontine angle. Case report. J. Neurosurg. 28:480–482, 1968.
Bullitt E., Tew J.M., Boyd J.:Intracranial tumors in patients with facial pain. J. Neurosurg. 64:865–871, 1986.
Cruccu G., Leandri M., Feliciani M., Manfredi M.:Idiopathic and symptomatic trigeminal pain. J. Neurol. Neurosurg. Psychiatry 53:1034–1042, 1990.
Dandy W.E.:Concerning the cause of trigeminal neuralgia. Am. J. Surg. 24:447–455, 1934.
D'Errico A.:Meningiomas of the cerebellar fossa. J. Neurosurg. 7:227–232, 1950.
Epstein N., Epstein F., Allen J.C., Aleksic S.:Intractable facial pain associated with a ganglioglioma of the cervicomedullary junction: report of a case. Neurosurgery 10:612–616, 1982.
Fromm G.H., Terrence C.M., Maroon J.C.:Trigeminal neuralgia. Current concepts regarding etiology and pathogenesis. Arch. Neurol. 41:1204–1207, 1984.
Gardner W.J.:Trigeminal neuralgia. Clin. Neurosurg. 15:1–56, 1968.
Gonzalez Revilla A.:Tic douloureux and its relationship to tumors of the posterior fossa. Analysis of twenty-four cases. J. Neurosurg. 4:233–239, 1947.
Gorelick P.B., Masdeu J.C.:Trigeminal neuralgia. Use of CT to uncover underlying brain tumor. I.M.J. 160:225–227, 1981.
Graves V.B., Schemm G.W.:Clinical characteristics and CT findings in lipoma of the cerebellopontine angle. J. Neurosurg. 57:839–841, 1982.
Hutchins L.G., Harnsberger H.R., Jacobs J.M., Apfelbaum R.I.:Trigeminal neuralgia (tic douloureux): MR imaging assessment. Radiology 175:837–841, 1990.
Jannetta P.J.:Microsurgery of cranial nerve gross compression. Clin. Neurosurg. 26:607–615, 1979.
Kimura J., Rodnitzky R.L., van Allen W.M.:Electrodiagnostic study of the trigeminal nerve: orbicularis oculi reflex and masseter reflex in trigeminal neuralgia, paratrigeminal syndrome and other lesions of the trigeminal nerve. Neurology 20:574–583, 1970.
Koenig M., Kalyan-Raman K., Sureka O.M.N.:Contralateral trigeminal nerve dysfunction as a false localizing sign in acoustic neuroma: a clinical and electrophysiological study. Neurosurgery 14:335–337, 1984.
Ongerboer De Visser B.W., Goor C.:Electromyographic and reflex study in idiopathic and symptomatic trigeminal neuralgias: latency of the jaw and blink reflexes. J. Neurol. Neurosurg. Psychiatry 37:1225–1230, 1974.
Pollack I.F., Sekhar L.N., Jannetta P.J., Janecka I.P.:Neurilemmomas of the trigeminal nerve. J. Neurosurg. 70:737–745, 1989.
Saito N., Yamakawa K., Sasaki T., et al.,Intramedullary cavernous angioma with trigeminal neuralgia: a case report and review of the literature. Neurosurgery 25:97–101, 1989.
Sevick R.J., Dillon W.P., Engstrom J., et al.:Trigeminal neuropathy: Gd-DPTA enhanced MR imaging. J. Comput. Assist. Tomogr. 15:605–611, 1991.
Tash R.R., Sze G., Leslie D.R.:Trigeminal neuralgia: MR imaging features. Radiology 172:767–770, 1989.
Weisenburg T.H.:Cerebello-pontine tumor diagnosed for six years as tic douloureux. The symptoms of irritation of the ninth and twelfth cranial nerve. J.A.M.A. 54:1600–1604, 1910.
Wepsic J.G.:Tic douloureux: etiology, refined treatment. N. Engl. J. Med. 288:680–681, 1973.
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Puca, A., Meglio, M. Typical trigeminal neuralgia associated with posterior cranial fossa tumors. Ital J Neuro Sci 14, 549–552 (1993). https://doi.org/10.1007/BF02339213
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DOI: https://doi.org/10.1007/BF02339213