Trigeminal Neuralgia Completely Relieved after Stent Assisted Coiling of a Superior Cerebellar Artery Aneurysm

Abstract Background Although secondary trigeminal neuralgia is usually due to tumours or multiple sclerosis, other major neurological diseases, such as aneurysms, should be taken into account when the history or the symptoms suggest a secondary origin. Case description A 67-year-old lady presented with a 6-month history of trigeminal neuralgia involving exclusively the right ophthalmic division. A dedicated 3D-MRI-MRA study documented a very rare contact with a wide-necked aneurysm of the superior cerebellar artery, which distorted the trigeminal root. The patient underwent an endovascular treatment by stent assisted coiling with the complete disappearance of the neuralgic pain attacks within 24 hours. Conclusion The complete relief from the neuralgic paroxysms immediately after endovascular stent assisted occlusion of a superior cerebellar artery aneurysm demonstrates the crucial role of a pulsating stimulus on the demyelinated nerve fibres in evoking the ectopically-generated discharges.