Parapontine trigeminal cryptic angiomas presenting as trigeminal neuralgia

Posterior fossa microvascular decompression surgery was attempted in 1257 patients with trigeminal neuralgia (TN), of whom seven had a very unusual cryptic angioma. The lesions were not visualized on preoperative enhanced computerized tomography scans, and serial angiography demonstrated a small vascular stain in only one case. The character of the facial pain was indistinguishable from TN caused by vascular compression and there was no other specific symptomatology. The patients' age and sex distributions were also compatible with classical TN. Cryptic angiomas presenting as typical TN without other symptoms have not been reported before, but they should be kept in mind in the differential diagnosis and surgical management of TN.