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Updated: Apr 20, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Decision-making in classic trigeminal neuralgia concurrent with a pontine cavernous malformation: Causal or
Maud Parise1, Marcus André Acioly2, Maurice Vincent3
1Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Surgical Specialties, Division of Neurosurgery, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract:
Trigeminal neuralgia is classically associated with neurovascular compression of the trigeminal nerve, at the root entry zone (REZ). However, patients are occasionally affected by intra-axial involvement of trigeminal sensory fibers caused by demyelinating diseases, strokes and, rarely, pontine cavernous malformations. We discuss the management strategies and decision-making process in a 55-year-old patient, affected by trigeminal neuralgia with 2 potential causative mechanisms: a neurovascular conflict at the trigeminal REZ and an ipsilateral cavernous malformation at the pontine nucleus of the trigeminal nerve.
