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Aberrant Abducent Nerve during Microvascular Decompression for Trigeminal Neuralgia

Borg, A; Zrinzo, L; (2020) Aberrant Abducent Nerve during Microvascular Decompression for Trigeminal Neuralgia. World Neurosurgery , 138 pp. 454-456. 10.1016/j.wneu.2020.03.115. Green open access

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Abstract

Background: Microvascular decompression (MVD) is a commonly performed procedure to treat trigeminal neuralgia and hemifacial spasm. Knowledge of the variable anatomy of the cerebellopontine angle is crucial to avoid injury to cranial nerves. Case Description: A 76-year-old lady with right V1 (ophthalmic division of the trigeminal nerve) and V2 (maxillary division of the trigeminal nerve) trigeminal neuralgia, refractory to medical treatment, underwent elective MVD. Intraoperatively, a distorted course of the cisternal component of the abducent nerve was noticed, caused by an ectatic anterior inferior cerebellar artery. Careful mobilization of the offending vessel to decompress the trigeminal nerve was carried out; however, abducent nerve decompression was not attempted since its function was not compromised. Facial pain resolved postoperatively without new diplopia. Conclusions: Careful review of imaging before surgery is recommended in order to preempt such unusual anatomic variations.

Type: Article
Title: Aberrant Abducent Nerve during Microvascular Decompression for Trigeminal Neuralgia
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.wneu.2020.03.115
Publisher version: https://doi.org/10.1016/j.wneu.2020.03.115
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Microvascular decompression, Trigeminal neuralgia, Abducent nerve, Facial pain, Aberrant vascular loop
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10095481
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