Radiation induced vascular injury after stereotactic radiosurgery for trigeminal neuralgia: Case report

BACKGROUND Stereotactic radiosurgery is increasingly used for the treatment of medical ly unresponsive trigeminal neuralgia. CASE DESCRIPTION We present the case of a 69-year-old man with trigeminal neuralgia who unde rwent stereotactic radiosurgery after a failed balloon compression procedur e. The radiosurgery also failed to provide the patient with any significant pain relief, and microvascular decompression of the trigeminal nerve was p erformed 10 months later. At operation, two adjacent veins and the superior cerebellar artery were noted to have focal changes consistent with atherom atous disease. CONCLUSION We postulate that the recent radiation exposure resulted in the observed va scular injury. As a result, patients having trigeminal neuralgia radiosurge ry need to be followed carefully for possible delayed ischemic events secon dary to radiation-induced vascular injury. (C) 2000 by Elsevier Science Inc .