{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:51Z","timestamp":1787025771384,"version":"build-2736575974"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Trigeminal neuralgia as the presenting symptom of brain arteriovenous malformation (bAVM) has been rarely reported. Treatment of reported cases has been skewed toward surgery for these scarce, deeply located bAVMs. Here, the authors report their management and outcomes of bAVM patients presenting with ipsilateral trigeminal neuralgia (TN) at their institution.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This is a retrospective cohort study. The authors\u2019 institutional bAVM database was queried for non\u2013hereditary hemorrhagic telangiectasia bAVMs in pontine, cistern, brainstem, trigeminal nerve, or tentorial locations. Patients with complete data were included in a search for trigeminal neuralgia or \"facial pain\" as the presenting symptom with TN being on the same side as the bAVM. Demographics, TN and bAVM characteristics, management strategies, and outcomes of bAVM and TN management were analyzed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Fifty-seven peripontine bAVMs were identified; 8 (14.0%) of these bAVMs were discovered because of ipsilateral TN, including 4 patients (50%) with facial pain in the V2 distribution. Five patients (62.5%) were treated with carbamazepine as the initial medical therapy, 2 (25%) underwent multiple rhizotomies, and 1 (12.5%) underwent microvascular decompression. None of the patients with TN-associated bAVMs presented with hemorrhage, compared with 25 patients (51%) with bAVMs that were not associated with TN (p < 0.01). TN-associated bAVMs were overall smaller than non\u2013TN-associated bAVMs, but the difference was not statistically significant (1.71 cm vs 2.22 cm, p = 0.117), and the Spetzler-Martin grades were similar. Six patients (75%) underwent radiosurgery to the bAVM (mean dose 1800 cGy, mean target volume 0.563 cm\n 3<\/jats:sup>\n ) and had complete resolution of TN symptoms (100%). The mean time from radiosurgery to TN resolution was 193 (range 21\u2013360) days, and 83.3% of treated TN-associated bAVMs were obliterated via radiosurgery. Two patients (12.5%) were recommended for conservative management, with one undergoing subsequent rhizotomies and another patient died of hemorrhage during follow-up.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n TN-associated bAVM is a rare condition with limited evidence for management guidance. Radiosurgery can be safe and effective in achieving durable TN control in patients with TN-associated bAVMs. Despite their deep location and unruptured presentation, obliteration can reach 83.3% with radiosurgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2023.5.jns23771","type":"journal-article","created":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T04:44:47Z","timestamp":1689396287000},"page":"515-521","source":"Crossref","is-referenced-by-count":2,"title":["Management outcomes of peripontine arteriovenous malformation patients presenting with trigeminal neuralgia"],"prefix":"10.3171","volume":"140","author":[{"given":"Wuyang","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahab Aldin","family":"Sattari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Feghali","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risheng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetan","family":"Bettegowda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"N Engl J Med","first-page":"754","article-title":"Trigeminal neuralgia","volume":"383","author":"Cruccu G","year":"2020","unstructured":"Cruccu G, Di Stefano G, Truini A. Trigeminal neuralgia. N Engl J Med. 2020;383(8):754\u2013762."},{"issue":"6","key":"b2","series-title":"Pain","first-page":"1166","article-title":"Evaluating the impact of trigeminal neuralgia","volume":"158","author":"Zakrzewska JM","year":"2017","unstructured":"Zakrzewska JM, Wu J, Mon-Williams M, Phillips N, Pavitt SH. Evaluating the impact of trigeminal neuralgia. Pain. 2017;158(6):1166\u20131174."},{"issue":"Pt 12","key":"b3","series-title":"Brain","first-page":"2347","article-title":"Trigeminal neuralgia: pathology and pathogenesis","volume":"124","author":"Love S","year":"2001","unstructured":"Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124(Pt 12):2347-2360."},{"key":"b4","series-title":"J Pain Res","first-page":"3437","article-title":"Trigeminal neuralgia: current approaches and emerging interventions","volume":"14","author":"Xu R","year":"2021","unstructured":"Xu R, Xie ME, Jackson CM. Trigeminal neuralgia: current approaches and emerging interventions. J Pain Res. 2021;14:3437\u20133463."},{"issue":"10","key":"b5","series-title":"Curr Pain Headache Rep","first-page":"74","article-title":"A comprehensive review of trigeminal neuralgia","volume":"23","author":"Jones MR","year":"2019","unstructured":"Jones MR, Urits I, Ehrhardt KP, A comprehensive review of trigeminal neuralgia. Curr Pain Headache Rep. 2019;23(10):74."},{"issue":"7","key":"b6","series-title":"Cephalalgia","first-page":"648","article-title":"Trigeminal neuralgia\u2014diagnosis and treatment","volume":"37","author":"Maarbjerg S","year":"2017","unstructured":"Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia\u2014diagnosis and treatment. 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Surg Neurol Int. 2021;12:318."},{"issue":"3","key":"b24","series-title":"Neurol India","first-page":"744","article-title":"Trigeminal neuralgia from an arteriovenous malformation of the trigeminal root entry zone with a flow-related feeding artery aneurysm: the role of a combined endovascular and \"tailored\" surgical treatment","volume":"69","author":"Das KK","year":"2021","unstructured":"Das KK, Gosal JS, Ashish K, Gandhi A, Jaiswal AK, Behari S. Trigeminal neuralgia from an arteriovenous malformation of the trigeminal root entry zone with a flow-related feeding artery aneurysm: the role of a combined endovascular and \"tailored\" surgical treatment. Neurol India. 2021;69(3):744\u2013747."},{"issue":"1","key":"b25","series-title":"Br J Neurosurg","first-page":"113","article-title":"Trigeminal neuralgia from an arteriovenous malformation: an intra-operative diagnosis","volume":"29","author":"Jayasekera BAP","year":"2015","unstructured":"Jayasekera BAP, Vergani F, Gholkar A, Jenkins AJ. Trigeminal neuralgia from an arteriovenous malformation: an intra-operative diagnosis. Br J Neurosurg. 2015;29(1):113\u2013114."},{"issue":"4","key":"b26","series-title":"J Neurosurg","first-page":"874","article-title":"Trigeminal neuralgia caused by microarteriovenous malformations of the trigeminal nerve root entry zone: symptomatic relief following complete excision of the lesion with nerve root preservation","volume":"97","author":"Edwards RJ","year":"2002","unstructured":"Edwards RJ, Clarke Y, Renowden SA, Coakham HB. Trigeminal neuralgia caused by microarteriovenous malformations of the trigeminal nerve root entry zone: symptomatic relief following complete excision of the lesion with nerve root preservation. J Neurosurg. 2002;97(4):874\u2013880."},{"issue":"1","key":"b27","series-title":"Exp Ther Med","first-page":"69","article-title":"Trigeminal neuralgia caused by brain arteriovenous malformations: a case report and literature review","volume":"12","author":"Yuan Y","year":"2016","unstructured":"Yuan Y, Zhang Y, Luo QI, Yu J. Trigeminal neuralgia caused by brain arteriovenous malformations: a case report and literature review. Exp Ther Med. 2016;12(1):69\u201380."},{"issue":"6","key":"b28","series-title":"J Neurosurg","first-page":"1318","article-title":"Trigeminal neuralgia associated with contralateral cerebellar arteriovenous malformation. Case illustration","volume":"98","author":"Sato K","year":"2003","unstructured":"Sato K, Jokura H, Shirane R, Akabane T, Karibe H, Yoshimoto T. 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J Neurosurg. 2018;130(3):733\u2013757."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/2\/article-p515.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/2\/article-p515.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/2\/article-p515.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T06:22:50Z","timestamp":1716618170000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/2\/article-p515.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2023.5.jns23771","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}