Concurrent trigeminal and glossopharyngeal neuralgia, hemifacial spasm and hypertension by neurovascular compression....

The case is reported of a 58 year-old man with left-sided trigeminal and glossopharyngeal neuralgia, left hemifacial spasm and arterial hypertension. Preoperative MRI angiography examination showed a massively ectatic left vertebral artery. At operation a multiple neurovascular compression, which is described, was discovered. Microvascular decompression was performed and postoperatively the patient had complete relief from the trigeminal and glossopharyngeal neuralgia, from the hemifacial spasm, and has sustained normal arterial pressure without medication. The value of MRI in diagnosing of neurovascular compression syndromes and pathophysiology of the "so called" arterial hypertension are discussed.