Resolution of Trigeminal Neuralgia After Transvenous Embolization of a Cavernous Sinus Dural Arteriovenous Fistula

Background Trigeminal neuralgia (TN) resulting from a dural arteriovenous fistula (DAVF) are rare. A case of cavernous sinus dural arteriovenous fistula (CSDAVF) in a patient with TN that resolved immediately after transvenous embolization (TVE) is described. Case Description A 75-year-old woman presented with continuous facial pain. On time-of-flight magnetic resonance angiography (MRA), a CSDAVF was suspected, and digital subtraction angiography (DSA) showed a CSDAVF. The TN completely resolved immediately after TVE, with no recurrence. Follow-up MRA showed complete obliteration of the fistula 13 months after TVE. Conclusions The pulsatile flow at the posteromedial part of the cavernous sinus might have compressed the upper aspect of the Gasserian ganglion, causing TN. Disappearance of pulsatile flow after TVE might result in complete resolution of TN.