Neurovascular Compression Associated with Trigeminal Neuralgia and Systemic Arterial Hypertension: Surgical Treatment

Objective and Importance: To highlight arterial hypertension as an additional factor favoring surgical indication in neurovascular compression syndromes such as trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. Clinical Presentation: A 52-year-old woman with trigeminal neuralgia concomitant with systemic arterial hypertension, submitted initially to unsatisfactory conservative treatment, presents tortuousness and enlargement of the vertebral artery (VA) topography on magnetic resonance imaging (MRI). A microsurgical neurovascular decompression of the trigeminal nerve and the medulla was performed, revealing that the compression was due to the superior cerebellar artery instead of the VA. Both the neuralgia and the hypertension were controlled with no need of medication during a 1-year follow-up. Conclusion: Surgical indication in neurovascular compression disorders should be reinforced in the presence of concomitant arterial hypertension and a compatible MRI examination.