case_images: PMC10734301_01
case_images: A malformed vascular mass in the left pontine cerebellar horn region seen on MRI scanning (A,B); Panel (C) is magnetic resonance angiography (MRA); and Panel (D) is unreconstructed CTA showing a clear vascular malformation.
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case_images: PMC10734301_01_fneur-14-1293056-g001.jpg
case_images: fig1
case_images: A curved mass of blood vessels was discovered close to the left trigeminal nerve in the brain during MRI and MRA scans (Figure 1).
case_images: Intraoperative pictures of patients in case report: the malformed vascular mass compresses the left trigeminal nerve and passes between the motor branches of the trigeminal nerve (A); sever the motor branch of the trigeminal nerve and free the malformed blood vessels (B); then the malformed blood vessels are completely free (C); and a gesket is inserted between the malformed vascular mass and the trigeminal nerve (D).
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case_images: PMC10734301_01_fneur-14-1293056-g002.jpg
case_images: fig2
case_images: Considering the patient's age is not old, the bleeding risk of the dural arteriovenous fistula is low, the intervention may embolize the draining vein of the brainstem, which may cause more serious consequences, and the trigeminal neuralgia is not necessarily resolved; combined with the opinions of the patient and his family, microvascular decompression surgery was finally chosen, in which the malformed vascular mass in the left side of the pontine angle area was seen to compress the trigeminal nerve, and the vasculature and nerves were separated, and two rocky veins were electrocoagulated and disconnected, which were close to the trigeminal nerve (Figure 2).
case_images: DSA of patients after MVD in case report: left vertebral arterial phase (A), left internal carotid system arterial phase (C), and venous phase (B,D) found no obvious abnormality.
case_images: fneur-14-1293056-g003.jpg
case_images: PMC10734301_01_fneur-14-1293056-g003.jpg
case_images: fig3
case_images: After 6 months, the patient was followed up and underwent total cerebral angiography, but no obvious abnormality was found (Figure 3), which was beyond our expectation, and this might be related to the fact that the rock vein was dissected during the operation and the dural arteriovenous fistula was not serious.