Basilar artery ectasia: an unusual cause of trigeminal neuralgia

Basilar artery ectasia may be associated with trigeminal neuralgia as a consequence of trigeminal nerve compression by the aberrant artery. The case histories are presented of four patients, investigation of whom demonstrated the presence of an ectatic basilar artery thought to be the cause of facial pain. The value of intravenous digital subtraction angiography in the investigation of this condition is emphasised. The surgical management is discussed with particular reference to the choice between percutaneous thermocoagulation and posterior fossa microvascular decompression.