Adachi Kazuhide, Hasegawa Mitsuhiro, Hayashi Takuro, Nagahisa Shinya, Hirose Yuichi
Department of Neurosurgery, School of Medicine, Fujita Health University, 1-98, Kutsugake Dengakugakubo, Toyoake City, Aichi 470-1192, Japan.
Department of Neurosurgery, School of Medicine, Fujita Health University, 1-98, Kutsugake Dengakugakubo, Toyoake City, Aichi 470-1192, Japan.
Clin Neurol Neurosurg. 2014 Oct;125:151-4. doi: 10.1016/j.clineuro.2014.07.025. Epub 2014 Jul 30.
Cavernous malformation with trigeminal neuralgia is relatively rare; only 10 cases have been reported. In deciding treatment strategies, it is helpful to classify cavernous malformation according to its origin, as follows: in the Gasserian ganglion (Type G); between the cisternal and intra-axial portions of the trigeminal nerve root (Type C); in the intra-axial trigeminal nerve root in the pons (Type P); or in the spinal tract of the trigeminal nerve root (Type S). A 62-year-old male presented with left trigeminal neuralgia (V2 area) and left facial hypoesthesia. Imaging studies revealed a cerebellopontine angle mass lesion with characteristics of a cavernous malformation and evidence of hemorrhage. The lesion was completely removed via a left anterior transpetrosal approach. The mass was attached to the trigeminal nerve root; it was located between the cisternal and intra-axial portions of the nerve root, and feeding off microvessels from the trigeminal nerve vascular plexus. Histological examination confirmed a cavernous malformation. In this case, the cavernous malformation was Type C. We review cases of cavernous malformation with trigeminal neuralgia and discuss therapeutic strategies according to the area of origin.
海绵状血管畸形伴三叉神经痛相对罕见，仅报道过10例。在制定治疗策略时，根据海绵状血管畸形的起源进行分类有助于治疗，分类如下：位于半月神经节（G型）；位于三叉神经根的脑池段和轴内段之间（C型）；位于脑桥内的三叉神经根轴内段（P型）；或位于三叉神经根的脊髓束内（S型）。一名62岁男性患者，表现为左侧三叉神经痛（V2区域）和左侧面部感觉减退。影像学检查显示桥小脑角有一肿块病变，具有海绵状血管畸形特征并有出血迹象。通过左侧经岩骨前入路将病变完全切除。肿块附着于三叉神经根，位于神经根的脑池段和轴内段之间，并由三叉神经血管丛的微血管供血。组织学检查证实为海绵状血管畸形。该病例中的海绵状血管畸形为C型。我们回顾了海绵状血管畸形伴三叉神经痛的病例，并根据起源部位讨论了治疗策略。
