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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1809909
Case Report

Microvascular Decompression for Trigeminal Neuralgia Secondary to Vertebrobasilar Dolichoectasia: a Case Report and Review of the Literature

Fabiane Caxias de Paula Carvalho 
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
,
Joaquim Francisco Cavalcante-Neto 
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
,
Francisco Jazon de Araújo Neto 
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
,
Paulo Roberto Matos-Neto
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
,
Lucas Antonissen Lima Verde
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
,
Gerardo Cristino-Filho
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
2   Department of Neurosurgery, North Regional Hospital, Sobral, Ceará, Brazil
,
Paulo Roberto Lacerda Leal
1   Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil
2   Department of Neurosurgery, North Regional Hospital, Sobral, Ceará, Brazil
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Abstract

Vertebrobasilar dolichoectasia (VBD) is a vasculopathy characterized by elongation and dilation of the affected artery. We present a case of trigeminal neuralgia (TN) secondary to VBD, successfully treated with microvascular decompression (MVD) using an autologous muscle graft (AMG). Additionally, we conducted a review of the literature and meta-analysis of 14 studies involving 303 patients to evaluate the efficacy of this surgical approach. A 63-year-old man experienced recurrent, lancinating pain in the V1, V2, and V3 branches of the right trigeminal nerve. Due to the intractable symptoms, he underwent MVD with an AMG after thorough neurological evaluation. At the 1-year follow-up, he was pain-free without the need for further medication. TN secondary to VBD is a rare and challenging condition, often refractory to medical treatment. MVD with an AMG offers significant symptom relief. Further research, including prospective studies or randomized controlled trials comparing AMG with other graft materials, is necessary to confirm its efficacy.

Keywords

microvascular decompression - autologous muscle grafts - trigeminal neuralgia - vertebrobasilar dolichoectasia - systematic review - meta-analysis

Authors' Contributions

F.C.P.C. formulated the research question and developed the search strategy, screened the articles and extracted the data, synthesized the results, and drafted the manuscript. J.F.C.-N. performed the quality assessment and provided critical insights and supervision. F.J.A.N. performed the statistical analysis and drafted the manuscript. P.R.M.-N. screened the articles, extracted the data, and drafted the manuscript. L.A.L.V. screened the articles, extracted the data, and drafted the manuscript. G.C.-F. revised the manuscript and provided expert input. P.R.L.L. revised the manuscript and provided expert input.


Patients' Consent

Informed consent was obtained from the patient included in this study.


Supplementary Material



Publication History

Article published online:
25 June 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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