[Brain stem compression preceded by trigeminal neuralgia in a patient with vertebro-basilar and bilateral carotid dolichoectasia].

We described a patient who had left trigeminal neuralgia by vertebro-basilar dolichoectasia, who underwent microvascular decompression separating the basilar artery of the trigeminal nerve by interposing a vascular graft piece. Symptoms resolved completely after surgery. Nine years later, he has a recurrence of facial pain associated with rapidly progressive brainstem compressive symptoms. The brain MRI showed the vertebro-basilar dolichoectasia exerting compression on the ventral-lateral aspect of the pons and the medulla. In cerebral angiography confirmed the presence of dilated tortuous vertebral arteries, basilar, and of both internal carotid. To our knowledge this is the first case of brain stem compression syndrome preceded by NT in patients with vertebro-basilar dolichoectasia and one of the few cases with coexistence of vertebro-basilar and bilateral carotid dolichoectasia.