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Al-Smair A, Mahmoud MM, Haj-Ahmad LM, Younes S, Saadeh A, Kakish E. Absent Meckel's cave as a possible cause of trigeminal neuralgia: A case report. Radiol Case Rep 2023; 18:1482-1484. [PMID: 36747907 PMCID: PMC9898280 DOI: 10.1016/j.radcr.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/09/2022] [Indexed: 02/04/2023] Open
Abstract
Trigeminal neuralgia (TN) is a debilitating yet potentially treatable facial pain disorder.TN is difficult to miss clinically, as patients' clinical presentation is often strikingly stereotypical: unilateral, paroxysmal, stimulus-dependent pain involving the trigeminal territory. Magnetic resonance imaging (MRI), which is used for further evaluation of an underlying etiology of TN, most commonly shows neurovascular compression of the trigeminal nerve to be the culprit. Secondary etiologies, though less common, do exist. An absent Meckel's cave with ipsilateral TN was reported in a few case reports and series, and whether an etiological relationship exists is yet to be established. We herein present a case of a 22-year-old female patient who presented with typical TN clinical manifestations. MRI was ordered to assess for the underlying cause and an ipsilateral absent Meckel's cave was the only significant finding. This case report adds to the scarcity of literature highlighting this entity, further larger clinical studies are needed to establish a causal relationship.
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Affiliation(s)
- Ali Al-Smair
- Medray International Radiology Center, Amman, Jordan
| | | | | | - Sara Younes
- The University of Jordan, Faculty of Medicine, Amman, Jordan
| | - Ahmad Saadeh
- The University of Jordan, Faculty of Medicine, Amman, Jordan
- Corresponding author.
| | - Eid Kakish
- Medray International Radiology Center, Amman, Jordan
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AlHatmi A, Al-Qassabi A, Raniga SB, Al Ajmi E. Absence of Meckel's Cave with Trigeminal Neuralgia: A Case Report. Indian J Radiol Imaging 2022; 33:124-128. [PMID: 36855729 PMCID: PMC9968541 DOI: 10.1055/s-0042-1759638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Trigeminal neuralgia (TN) is a disabling painful condition along the course of the sensory distribution of the trigeminal nerve that most commonly occurs due to vascular compression or conflict at the root entry zone of the trigeminal nerve. We report a 27-year-old female patient who presented with pain and an electric shock-like sensation on the right side of her face that started three years ago. Magnetic resonance imaging of the brain was done and revealed no neurovascular conflict along the course of the trigeminal nerve. The absence of Meckel's cave with atrophy of the cisternal segment of the trigeminal nerve on the affected side was reported. The absence of Meckel's cave is an exceedingly rare cause of TN, and only a handful of reported cases in the literature suggest the association between them.
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Affiliation(s)
- Asma AlHatmi
- Department of Radiology, Ibri Hospital, Ibri, Oman
| | - Ahmed Al-Qassabi
- Division of Neurology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Al-Khoudh, Oman
| | - Sameer Bhimjibhai Raniga
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Al-Khoudh, Oman
| | - Eiman Al Ajmi
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Al-Khoudh, Oman,Address for correspondence Eiman Al Ajmi, MD, FRCPC, FRCR Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Sultan Qaboos UniversityMuscat, Al-Khoudh 123Oman
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Xia Y, Yu G, Min F, Xiang H, Huang J, Leng J. The Focus and New Progress of Percutaneous Balloon Compression for the Treatment of Trigeminal Neuralgia. J Pain Res 2022; 15:3059-3068. [PMID: 36199499 PMCID: PMC9529012 DOI: 10.2147/jpr.s374433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Trigeminal neuralgia is a condition confined to the trigeminal nerve, causing one or more branches of facial nerve pain. Surgical treatment options for trigeminal neuralgia include microvascular decompression(MVD), percutaneous balloon compression (PBC), radiofrequency thermocoagulation(RF), percutaneous retrogasserian glycerol rhizotomy(PRGR), gamma knife, etc. Of these treatments, PBC is increasingly being used by clinicians for trigeminal neuralgia. PBC is a simple surgical operation performed to treat trigeminal neuralgia. Owing to its advantages, PBC is favored by many clinicians. In this study, we aimed to emphasize the need to analyze the shape of the balloon, position, compression time, and pressure, as these factors can affect the efficacy of PBC. The relief of pain by balloon compression is related to the shape of the balloon on X-ray, which is the key to the operation. Owing to continued progress and advances in current imaging technologies, clinicians revealed that the precise positioning of the foramen ovale is no longer an intraoperative problem. Instead, the anatomy of Meckel’s cave and the shape of the balloon must be the focus to achieve the best treatment effect. For clinicians, PBC is simple and is associated with a short operation time. PBC also has other advantages, such as low cost and immediate postoperative pain relief. The recurrence rate of pain post-PBC is low, despite the occurrence of facial numbness post-op. However, this side effect is reversible and does not affect daily life of the patient. In fact, the patient can be discharged 1–2 days after surgery. Overall, PBC can be considered as one of the preferred surgical methods for the treatment of primary trigeminal neuralgia. In this paper, we explain the main points of PBC operation in detail in terms of Meckel’s cave, surgical procedure, complications, discussion of the focus and new progress, etc.
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Affiliation(s)
- Yinghua Xia
- Medical College of Nanchang University, Nanchang, People’s Republic of China
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
| | - Gui Yu
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
- The First Clinical Medical College of Gannan Medical University, Ganzhou, People’s Republic of China
| | - Feixiang Min
- Medical College of Nanchang University, Nanchang, People’s Republic of China
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
| | - Hui Xiang
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
- Correspondence: Hui Xiang, Jiangxi Provincial People’s Hospital, No. 266, Fenghe North Avenue, Honggutan District, Nanchang City, People’s Republic of China, Tel +86-13803514563, Email
| | - Jinqing Huang
- Department of Neurosurgery, Ganzhou People’s Hospital, Ganzhou, People’s Republic of China
- Department of Neurosurgery, the Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, People’s Republic of China
- Jinqing Huang, Ganzhou People’s Hospital, No. 16, Meiguan Avenue, Zhanggong District, Ganzhou City, People’s Republic of China, Tel +86-18160779765, Email
| | - Jingxing Leng
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
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