Alternative option for osteogenesis imperfecta and trigeminal neuralgia

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Osteogenesis imperfecta (OI) can cause skull base deformities, leading to trigeminal nerve compression and severe trigeminal neuralgia.
• Anatomical distortions in OI present significant challenges for standard trigeminal neuralgia treatments.

Observation:

• A 28-year-old woman with OI and severe trigeminal neuralgia underwent percutaneous balloon microcompression.
• The procedure involved CT and radiographic-guided cannulation of the Gasserian ganglion without neuronavigation or stereotactic devices.

Findings:

• The patient experienced good pain control with resultant hypoesthesia in the left V1, V2, and V3 trigeminal nerve segments.
• This CT-guided percutaneous technique, performed in an angiosuite, proved effective.

Implications:

• This CT-guided percutaneous balloon microcompression offers a safe, efficient, and alternative treatment for trigeminal neuralgia in patients with OI and other skull base deformities.
• The technique avoids the need for specialized equipment like Mayfield clamps or stereotactic systems, making it more accessible.