case_images: PMC8326083_01
case_images: AP cerebral angiogram showing a right vertebral artery injection. Indicated by the arrows are the right SCA and the right PCA, both occluded postembolization. SCA: Superior cerebellar artery, PCA: Posterior cerebellar artery.
case_images: SNI-12-318-g001.jpg
case_images: PMC8326083_01_SNI-12-318-g001.jpg
case_images: F1
case_images: She underwent a diagnostic cerebral angiography which showed total occlusion of the previously embolized AVM along with distal occlusion of the right posterior cerebellar artery and SCA [Figure 1].
case_images: Axial sections of T1-weighted brain MRI with and without contrast showing the embolized right occipital intracranial arteriovenous malformation (red arrows) with the embolization material appearing as hyperintense.
case_images: SNI-12-318-g002.jpg
case_images: PMC8326083_01_SNI-12-318-g002.jpg
case_images: F2
case_images: Subsequent brain MRI showed the previously embolized AVM in the right occipital lobe [Figure 2], along with no evidence of a vascular loop impinging on the right trigeminal nerve that may explain her trigeminal neuralgia [Figure 3].
case_images: Axial section of T1-weighted brain MRI showing the right trigeminal nerve (red arrow) with no impinging vascular loop.
case_images: SNI-12-318-g003.jpg
case_images: PMC8326083_01_SNI-12-318-g003.jpg
case_images: F3
case_images: Subsequent brain MRI showed the previously embolized AVM in the right occipital lobe [Figure 2], along with no evidence of a vascular loop impinging on the right trigeminal nerve that may explain her trigeminal neuralgia [Figure 3].
case_images: Operative view showing the right trigeminal nerve (v) with the embolized superior cerebellar artery (black arrow) under the instrument. Note the seventh-eighth cranial nerve complex on the right (*).
case_images: SNI-12-318-g004.jpg
case_images: PMC8326083_01_SNI-12-318-g004.jpg
case_images: F4
case_images: A whitish tubular structure that resembled an empty vessel was noticed crossing and abutting the trigeminal nerve root entry zone [Figure 4].
case_images: Operative view showing the insertion of a Teflon sponge (red arrow) between the trigeminal nerve (v) and the embolized superior cerebellar artery (black arrow).
case_images: SNI-12-318-g005.jpg
case_images: PMC8326083_01_SNI-12-318-g005.jpg
case_images: F5
case_images: Teflon sponges which were inserted to separate the vessel from the mentioned structures it was compressing [Figure 5]. The dura and the muscle fascia were thereafter closed tightly and the procedure was completed.