{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:50:33Z","timestamp":1789577433131,"version":"build-2803163510"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"19","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Percutaneous treatment for trigeminal neuralgia is a safe and effective therapeutic methodology and can be accomplished in the form of balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation. These procedures are generally well tolerated and demonstrate minimal associated morbidity. Moreover, vascular complications of these procedures are exceedingly rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>We present the case of a 64-year-old female with prior microvascular decompression and balloon rhizotomy who presented after symptom recurrence and underwent a second balloon rhizotomy at our institution. Soon thereafter, she presented with pulsatile tinnitus and a right preauricular bruit on physical examination. Subsequent imaging revealed a middle meningeal artery (MMA) to pterygoid plexus fistula and an MMA pseudoaneurysm. Coil and Onxy embolization were used to manage the pseudoaneurysm and fistula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case illustrates the potential for MMA pseudoaneurysm formation as a complication of percutaneous trigeminal balloon rhizotomy, which has not been seen in the literature. Concurrent MMA-pterygoid plexus fistula is also a rarity demonstrated in this case.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23237","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T19:12:28Z","timestamp":1699297948000},"source":"Crossref","is-referenced-by-count":2,"title":["Middle meningeal artery pseudoaneurysm and pterygoid plexus fistula following percutaneous radiofrequency rhizotomy: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Rahim","family":"Ismail","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrek","family":"Schartz","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kessler","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","first-page":"e245","article-title":"Anatomic study of extracranial needle trajectory using Hartel technique for percutaneous treatment of trigeminal neuralgia","volume":"110","author":"Iwanaga J","year":"2018","unstructured":"Iwanaga J, Badaloni F, Laws T, Oskouian RJ, Tubbs RS. Anatomic study of extracranial needle trajectory using Hartel technique for percutaneous treatment of trigeminal neuralgia. World Neurosurg. 2018;110:e245\u2013e248."},{"key":"b2","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":"6","key":"b3","series-title":"Acta Neurochir (Wien)","first-page":"1623","article-title":"Comparison of first-time microvascular decompression with percutaneous surgery for trigeminal neuralgia: long-term outcomes and prognostic factors","volume":"163","author":"Noorani I","year":"2021","unstructured":"Noorani I, Lodge A, Durnford A, Vajramani G, Sparrow O. Comparison of first-time microvascular decompression with percutaneous surgery for trigeminal neuralgia: long-term outcomes and prognostic factors. Acta Neurochir (Wien). 2021;163(6):1623\u20131634."},{"key":"b4","series-title":"Neurosurgery","first-page":"25","article-title":"A review of percutaneous treatments for trigeminal neuralgia","volume":"10","author":"Cheng JS","year":"2014","unstructured":"Cheng JS, Lim DA, Chang EF, Barbaro NM. A review of percutaneous treatments for trigeminal neuralgia. Neurosurgery. 2014;10(suppl 1):25\u201333."},{"issue":"1","key":"b5","series-title":"Clin Neuroradiol","first-page":"103","article-title":"Middle meningeal arteriovenous fistula following percutaneous retrogasserian glycerol rhizotomy","volume":"26","author":"Champeaux C","year":"2016","unstructured":"Champeaux C, Shieff C. Middle meningeal arteriovenous fistula following percutaneous retrogasserian glycerol rhizotomy. Clin Neuroradiol. 2016;26(1):103\u2013107."},{"key":"b6","series-title":"Surg Neurol Int","first-page":"36","article-title":"Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils","volume":"8","author":"Gatto LAM","year":"2017","unstructured":"Gatto LAM, Tacla R, Koppe GL, Junior ZD. Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils. Surg Neurol Int. 2017;8:36."},{"issue":"5","key":"b7","series-title":"J Neurosurg","first-page":"700","article-title":"Carotid-cavernous fistula following percutaneous retrogasserian procedures. Report of two cases","volume":"51","author":"Sekhar LN","year":"1979","unstructured":"Sekhar LN, Heros RC, Kerber CW. Carotid-cavernous fistula following percutaneous retrogasserian procedures. Report of two cases. 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Turk Neurosurg. 2016;26(2):215\u2013218."},{"issue":"1","key":"b18","series-title":"Neurosurgery","first-page":"209","article-title":"Internal carotid-inferior petrosal sinus fistula complicating foramen ovale telemetry: successful treatment with detachable coils: case report and review","volume":"50","author":"Marshman LAG","year":"2002","unstructured":"Marshman LAG, Connor S, Polkey CE. Internal carotid-inferior petrosal sinus fistula complicating foramen ovale telemetry: successful treatment with detachable coils: case report and review. Neurosurgery. 2002;50(1):209\u2013212."},{"key":"b19","series-title":"Radiology of the Skull and Brain","first-page":"287","article-title":"Basal foramina and canals","author":"Sondheimer FK","year":"1971","unstructured":"Sondheimer FK. Basal foramina and canals. In: Newton TH, and Potts DG, eds. Radiology of the Skull and Brain. Mosby. 1971:287\u2013308."},{"issue":"5","key":"b20","series-title":"J Neurosurg","first-page":"1414","article-title":"Comprehensive anatomy of the foramen ovale critical to percutaneous stereotactic radiofrequency rhizotomy: cadaveric study of dry skulls","volume":"132","author":"Elnashar A","year":"2019","unstructured":"Elnashar A, Patel SK, Kurbanov A, Zvereva K, Keller JT, Grande AW. Comprehensive anatomy of the foramen ovale critical to percutaneous stereotactic radiofrequency rhizotomy: cadaveric study of dry skulls. J Neurosurg. 2019;132(5):1414\u20131422."},{"issue":"2","key":"b21","series-title":"Korean J Neurotrauma","first-page":"176","article-title":"Treatment of pseudoaneurysm of internal maxillary artery resulting from needle injury","volume":"15","author":"Kim NY","year":"2019","unstructured":"Kim NY, Kim JY, Pyen JS, Whan K, Cho SM, Choi JW. Treatment of pseudoaneurysm of internal maxillary artery resulting from needle injury. Korean J Neurotrauma. 2019;15(2):176\u2013181."},{"issue":"2","key":"b22","series-title":"Neurol India","first-page":"514","article-title":"Pseudoaneurysm as a late complication of gamma knife surgery for trigeminal neuralgia","volume":"66","author":"Pak S","year":"2018","unstructured":"Pak S, Cha D, Valencia D, Askaroglu Y, Short J, Bouz P. Pseudoaneurysm as a late complication of gamma knife surgery for trigeminal neuralgia. Neurol India. 2018;66(2):514\u2013515."},{"key":"b23","series-title":"Percutaneous Rhizotomy\u2014Placement Of Needle in the Foramen","author":"Cohen-Gadol A","year":"2016","unstructured":"Cohen-Gadol A. Percutaneous Rhizotomy\u2014Placement Of Needle in the Foramen. Neurosurgical Atlas; 2016."},{"key":"b24","article-title":"Neuroanatomy, pterygoid plexus","author":"Golub B","unstructured":"Golub B, Bordoni B Neuroanatomy, pterygoid plexus. https:\/\/europepmc.org\/article\/nbk\/nbk555896. Accessed March 1, 2023."},{"key":"b1","series-title":"World Neurosurg","first-page":"e245","article-title":"Anatomic study of extracranial needle trajectory using Hartel technique for percutaneous treatment of trigeminal neuralgia","volume":"110","author":"Iwanaga J","year":"2018","unstructured":"Iwanaga J, Badaloni F, Laws T, Oskouian RJ, Tubbs RS. Anatomic study of extracranial needle trajectory using Hartel technique for percutaneous treatment of trigeminal neuralgia. World Neurosurg. 2018;110:e245\u2013e248."},{"key":"b2","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":"6","key":"b3","series-title":"Acta Neurochir (Wien)","first-page":"1623","article-title":"Comparison of first-time microvascular decompression with percutaneous surgery for trigeminal neuralgia: long-term outcomes and prognostic factors","volume":"163","author":"Noorani I","year":"2021","unstructured":"Noorani I, Lodge A, Durnford A, Vajramani G, Sparrow O. Comparison of first-time microvascular decompression with percutaneous surgery for trigeminal neuralgia: long-term outcomes and prognostic factors. Acta Neurochir (Wien). 2021;163(6):1623\u20131634."},{"key":"b4","series-title":"Neurosurgery","first-page":"25","article-title":"A review of percutaneous treatments for trigeminal neuralgia","volume":"10","author":"Cheng JS","year":"2014","unstructured":"Cheng JS, Lim DA, Chang EF, Barbaro NM. A review of percutaneous treatments for trigeminal neuralgia. Neurosurgery. 2014;10(suppl 1):25\u201333."},{"issue":"1","key":"b5","series-title":"Clin Neuroradiol","first-page":"103","article-title":"Middle meningeal arteriovenous fistula following percutaneous retrogasserian glycerol rhizotomy","volume":"26","author":"Champeaux C","year":"2016","unstructured":"Champeaux C, Shieff C. Middle meningeal arteriovenous fistula following percutaneous retrogasserian glycerol rhizotomy. Clin Neuroradiol. 2016;26(1):103\u2013107."},{"key":"b6","series-title":"Surg Neurol Int","first-page":"36","article-title":"Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils","volume":"8","author":"Gatto LAM","year":"2017","unstructured":"Gatto LAM, Tacla R, Koppe GL, Junior ZD. Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils. Surg Neurol Int. 2017;8:36."},{"issue":"5","key":"b7","series-title":"J Neurosurg","first-page":"700","article-title":"Carotid-cavernous fistula following percutaneous retrogasserian procedures. Report of two cases","volume":"51","author":"Sekhar LN","year":"1979","unstructured":"Sekhar LN, Heros RC, Kerber CW. Carotid-cavernous fistula following percutaneous retrogasserian procedures. Report of two cases. J Neurosurg. 1979;51(5):700\u2013706."},{"issue":"4","key":"b8","series-title":"Clin Neurol Neurosurg","first-page":"269","article-title":"Carotid-cavernous fistula following percutaneous trigeminal ganglion approach","volume":"82","author":"G\u00f6kalp HZ","year":"1980","unstructured":"G\u00f6kalp HZ, Kanpolat Y, T\u00fcmer B. Carotid-cavernous fistula following percutaneous trigeminal ganglion approach. Clin Neurol Neurosurg. 1980;82(4):269\u2013272."},{"issue":"1","key":"b9","series-title":"J Neurosurg","first-page":"49","article-title":"A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion","volume":"72","author":"Lichtor T","year":"1990","unstructured":"Lichtor T, Mullan JF. A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg. 1990;72(1):49\u201354."},{"issue":"4","key":"b10","series-title":"J Neurosurg","first-page":"546","article-title":"Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia","volume":"72","author":"Lobato RD","year":"1990","unstructured":"Lobato RD, Rivas JJ, Sarabia R, Lamas E. Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. J Neurosurg. 1990;72(4):546\u2013553."},{"issue":"3","key":"b11","series-title":"J Neurosurg","first-page":"499","article-title":"External carotid artery fistula due to microcompression of the gasserian ganglion for relief of trigeminal neuralgia. Case report","volume":"78","author":"Revuelta R","year":"1993","unstructured":"Revuelta R, Nathal E, Balderrama J, Tello A, Zenteno M. External carotid artery fistula due to microcompression of the gasserian ganglion for relief of trigeminal neuralgia. Case report. J Neurosurg. 1993;78(3):499\u2013500."},{"issue":"4","key":"b12","series-title":"Neurosurgery","first-page":"853","article-title":"Direct carotid cavernous fistula after trigeminal balloon microcompression gangliolysis: case report","volume":"39","author":"Kuether TA","year":"1996","unstructured":"Kuether TA, O\u2019Neill OR, Nesbit GM, Barnwell SL. Direct carotid cavernous fistula after trigeminal balloon microcompression gangliolysis: case report. Neurosurgery. 1996;39(4):853\u2013856."},{"issue":"3","key":"b13","series-title":"Neurosurgery","first-page":"524","article-title":"Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients","volume":"48","author":"Kanpolat Y","year":"2001","unstructured":"Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients. Neurosurgery. 2001;48(3):524\u2013534."},{"issue":"1","key":"b14","series-title":"J Neurosurg","first-page":"176","article-title":"Cavernous sinus fistula following percutaneous balloon compression of the trigeminal ganglion. Case report","volume":"103","author":"Langford P","year":"2005","unstructured":"Langford P, Holt ME, Danks RA. Cavernous sinus fistula following percutaneous balloon compression of the trigeminal ganglion. Case report. J Neurosurg. 2005;103(1):176\u2013178."},{"issue":"4","key":"b15","series-title":"J Neurosurg Sci","first-page":"177","article-title":"Endosurgical repair of an iatrogenic facial arteriovenous fistula due to percutaneous trigeminal balloon rhizotomy","volume":"51","author":"Lesley WS","year":"2007","unstructured":"Lesley WS. Endosurgical repair of an iatrogenic facial arteriovenous fistula due to percutaneous trigeminal balloon rhizotomy. J Neurosurg Sci. 2007;51(4):177\u2013180."},{"issue":"2","key":"b16","series-title":"J Neurointerv Surg","first-page":"147","article-title":"Rare vascular complication of percutaneous balloon compression of trigeminal neuralgia treated endovascularly","volume":"2","author":"Niu T","year":"2010","unstructured":"Niu T, Kalia JS, Zaidat OO. Rare vascular complication of percutaneous balloon compression of trigeminal neuralgia treated endovascularly. J Neurointerv Surg. 2010;2(2):147\u2013149."},{"issue":"2","key":"b17","series-title":"Turk Neurosurg","first-page":"215","article-title":"Endovascular treatment of rare vascular complications of percutaneous balloon compression for trigeminal neuralgia","volume":"26","author":"Li F","year":"2016","unstructured":"Li F, Ma Y, Zou J,  Endovascular treatment of rare vascular complications of percutaneous balloon compression for trigeminal neuralgia. Turk Neurosurg. 2016;26(2):215\u2013218."},{"issue":"1","key":"b18","series-title":"Neurosurgery","first-page":"209","article-title":"Internal carotid-inferior petrosal sinus fistula complicating foramen ovale telemetry: successful treatment with detachable coils: case report and review","volume":"50","author":"Marshman LAG","year":"2002","unstructured":"Marshman LAG, Connor S, Polkey CE. Internal carotid-inferior petrosal sinus fistula complicating foramen ovale telemetry: successful treatment with detachable coils: case report and review. 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