Esteban Garcia Jesus Manuel, Mato Mañas David, Marco De Lucas Enrique, Garcia Catalan Guillermo, Lopez Gomez Patricia, Santos Jimenez Carlos, Laez Ruben Martin
Department of Neurosurgery, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
Surg Neurol Int. 2021 Mar 17;12:106. doi: 10.25259/SNI_371_2020. eCollection 2021.
Trigeminal neuralgia secondary to posterior and middle fossae tumors, whether ipsilateral or contralateral, has been well described. However, this disabling disease has never been reported in the context of anterior fossa neoplasms.
A 75-year-old female with right hemifacial pain was diagnosed with an anterior clinoid meningioma. Despite neuroimaging did not show any apparent anatomical or neurovascular conflict, a detailed MRI analysis revealed a V3 hyperintensity. Not only symptoms completely resolved after surgical resection but also this radiological sign disappeared. Nowadays, the patient remains asymptomatic and V3 hyperintensity has not reappeared during her follow-up.
A surgical definitive treatment can be offered to patients suffering from trigeminal neuralgia secondary to lesions adjacent to Gasserian ganglion or trigeminal branches. In this respect, posterior and middle fossae tumors are well-reported etiologies. Nevertheless, in the absence of evident compression, other neoplasms located in the vicinity of these critical structures and considered as radiological findings may be involved in trigeminal pain. Microvascular and pressure gradient changes could be an underlying cause of these symptoms in anterior skull base lesions. Here, we report the case of a patient with uncontrollable hemifacial pain resolved after anterior clinoid meningioma removal.
继发于后颅窝和中颅窝肿瘤的三叉神经痛，无论同侧或对侧，均已有详尽描述。然而，这种致残性疾病从未在前颅窝肿瘤的背景下被报道过。
一名75岁的右侧面部疼痛女性被诊断为前床突脑膜瘤。尽管神经影像学检查未显示任何明显的解剖学或神经血管冲突，但详细的MRI分析显示三叉神经第三支（V3）高信号。手术切除后不仅症状完全缓解，而且这种放射学征象也消失了。如今，患者仍无症状，随访期间V3高信号未再出现。
对于继发于半月神经节或三叉神经分支附近病变的三叉神经痛患者，可以提供手术根治性治疗。在这方面，后颅窝和中颅窝肿瘤是报道较多的病因。然而，在没有明显压迫的情况下，位于这些关键结构附近且被视为放射学表现的其他肿瘤可能与三叉神经痛有关。微血管和压力梯度变化可能是前颅底病变中这些症状的潜在原因。在此，我们报告一例前床突脑膜瘤切除后无法控制的面部疼痛得到缓解的病例。
