Resolution of Trigeminal Neuralgia After Surgical Disconnection of a Foramen Magnum Dural Arteriovenous Fistula.

BACKGROUND

Trigeminal neuralgia (TN) resulting from dural arteriovenous fistulas (DAVFs) is rare. TN caused by a foramen magnum DAVF has not been reported yet. We report a patient with TN caused by a foramen magnum DAVF treated with surgical disconnection.

CASE DESCRIPTION: A 35-year-old man was admitted to our hospital with a right TN. Magnetic resonance imaging showed an abnormal flow void in the posterior fossa and a vascular structure next to the root entry zone of the right trigeminal nerve. Digital subtraction angiography showed a Cognard type IV DAVF located at the foramen magnum. The fistula was disconnected surgically. The patient was rendered completely pain-free, and the fistula did not recur during 4-year follow-up.

CONCLUSIONS

DAVF is a rare cause of TN. Surgical disconnection is an effective treatment method for TN caused by a foramen magnum DAVF.