Trigeminal Neuralgia Caused by Cerebellopontine Angle Tumors: Surgical Series
Arq. bras. neurocir; 38 (1), 2019
Publication year: 2019
Introduction Cerebellopontine angle (CPA) tumors represent an important cause of
persistent and refractory trigeminal neuralgia (TN). It is believed that between 1 and
9.9% of the cases of patients presenting with TN painful manifestation are caused by
space-occupying lesions.
Objective The objective of the present study is to describe the clinical and surgical
experience of the operative management of patients presenting with secondary type
TN associated with CPA tumors.
Method An observational investigation was conducted with data collection from
patients with secondary type TN associated with CPA tumors who were treated with
surgical resection of the space-occupying lesion and decompression of the trigeminal
nerve from January 2013 to November 2016 in 2 different centers in the western region
of the state of São Paulo, Brazil.
Results We operated on 11 consecutive cases in which TN was associated with CPA
during the period of analysis. Seven (63.6%) patients were female, and 4 (36.4%) were
male. Seven (63.6%) patients presented with right-side symptoms, and 4 (36.4%)
presented with left-side symptoms. After 2 years of follow-up, we observed that 8
(72.7%) patients showed a complete improvement of the symptoms, with an excellent
outcome, and that 3 (27.3%) patients showed an incomplete improvement, with a
good outcome. No patient reported partial improvement or poor outcome after the
follow-up. There was no operative mortality.
Conclusion Cerebellopontine angle tumors represent an important cause of TNandmust
be included in the differential diagnosis of patients presenting with refractory and persistent
symptoms. Surgical treatment with total resection of the expansive lesion and effective
decompression of the trigeminal nerve are essential steps to control the symptoms.