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 VIDEO SECTION-OPERATIVE NUANCES: STEP BY STEP
Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 826--828

Microvascular Decompression for Trigeminal Neuralgia with Concomitant Persistent Primitive Trigeminal Artery


Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Nishanth Sadashiva
Department of Neurosurgery, 2nd Floor, Neurosciences Faculty Block, National Institute of Mental Health and Neurosciences, Bengaluru - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.325353

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Background and Introduction: Apersistent primitive trigeminal artery (PPTA) is an embryonic vessel that connects the cavernous part of the internal carotid artery with the posterior circulation. Though many are incidental, it is associated with conditions such as trigeminal neuralgia (TN). Objective: In this video, we present a case of TN due to neurovascular conflict with associate PPTA. The close association of PPTA with trigeminal nerve results in increased incidence of TN. Surgical view and technique of surgery are described in the video. Surgical Technique: A 55-year-old male presented with medically refractory TN with imaging suggestive of neurovascular conflict. During surgery, the superior cerebellar artery was visibly causing compression of nerve and on inspection, the PPTA was in close association with the trigeminal nerve near the entry to Meckel's cave. Microvascular decompression was done using Teflon to separate the nerve from both SCA and PPTA. Conclusion: TN with PPTA is rare, and surgery and its nuances have rarely been described. This video shows the operative findings as well as describes the surgical technique.






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