Microvascular Decompression of a Rare Case of Trigeminal Neuralgia Arising From Dual Aica-Pica Compression on the Trigeminal Sensory Nucleus and Tract: An Illustrative Case Description.

This article describes a rare case of trigeminal neuralgia (TN) caused by compression on the trigeminal sensory nucleus and tract by an aberrant dual anastomotic artery loop. The patient, a 74-year-old male, experienced progressive episodic pain in the left forehead, eyelid, cheek, and jaw. Brain MRI revealed compression on the pons near the fourth ventricle caused by the left posterior inferior cerebellar artery (PICA) and an anastomotic loop connecting the anterior inferior cerebellar artery (AICA) and PICA. The patient underwent endoscopic-assisted microvascular decompression (MVD), which successfully relieved the pain. The article discusses the vulnerability of the trigeminal nerve to vascular forces and the effectiveness of MVD in reversing microstructural changes. It also highlights the need for further research on the mechanism and treatment of TN caused by vascular compression. [Extracted from the article]