RESUMO
A case is presented of painful tic convulsif caused by schwannoma in the cerebellopontine angle (CPA), with right trigeminal neuralgia and ipsilateral hemifacial spasm. Magnetic resonance images showed a 4 cm round mass displacing the 4th ventricle and distorting the brain stem in the right CPA. The schwannoma, which compressed the fifth and seventh cranial nerves directly, was subtotally removed by a suboccipital craniectomy. Postoperatively, the patient had a complete relief from the hemifacial spasm and marked improvement from trigeminal neuralgia. The painful tic convulsif in this case was probably produced by the tumor compressing and displacing the anterior cerebellar artery directly.
Assuntos
Feminino , Humanos , Neoplasias Cerebelares/complicações , Ângulo Cerebelopontino , Espasmo Hemifacial/etiologia , Pessoa de Meia-Idade , Neurilemoma/complicações , Neuralgia do Trigêmeo/etiologiaRESUMO
We report a case of"painful tic convulsif"caused by a tortous vertebrobasilar system, and present the case of a 59-year-old woman with right-sided trigeminal neuralgia and hemifacial spasm. Using a novel sequence, a dilated and severely elongated vertebrobasilar artery was demonstrated by magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA). During microvascular decompression, the findings of MRI were confirmed and decompression with teflon sheets between the nerves and offending arteries was successfully achieved. Postoperatively, the patient was relieved of pain and twitching.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Artérias , Descompressão , Espasmo Hemifacial , Imageamento por Ressonância Magnética , Cirurgia de Descompressão Microvascular , Politetrafluoretileno , Tiques , Neuralgia do TrigêmeoRESUMO
We report a case of"painful tic convulsif"caused by a tortous vertebrobasilar system, and present the case of a 59-year-old woman with right-sided trigeminal neuralgia and hemifacial spasm. Using a novel sequence, a dilated and severely elongated vertebrobasilar artery was demonstrated by magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA). During microvascular decompression, the findings of MRI were confirmed and decompression with teflon sheets between the nerves and offending arteries was successfully achieved. Postoperatively, the patient was relieved of pain and twitching.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Artérias , Descompressão , Espasmo Hemifacial , Imageamento por Ressonância Magnética , Cirurgia de Descompressão Microvascular , Politetrafluoretileno , Tiques , Neuralgia do TrigêmeoRESUMO
Trigeminal neuralgia is a cranial rhizopathy characterized by paroxysms of hyperactivity strictly limited to the anatomical distributions of the fifth cranial nerve. One of a documented cause is vascular cross-compression at the root entry zone of the fifth cranial nerve near the brain stem. The offending vessels are the superior cerebellar artery, anterior inferior cerebellar artery, small arteriole, vein only, and vertebrobasilar artery in order of frequency. When trigeminal neuralgia and hemifacial spasm occur together in the same patient in rare occasions, they are termed "tic convulsif" We have recently experienced three cases of trigeminal neurlgia caused by unusual offending vessels and one case of tic convulsif. They were treated by microvascular decompression using Teflon felt. Post-operative courses were uneventful and marked symptomatic improvement had been achieved.