{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T01:13:32Z","timestamp":1775870012005,"version":"3.50.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,11,18]]},"abstract":"\n BACKGROUND<\/jats:title>\n Trigeminal neuralgia (TN) can arise from trigeminal nerve compression at the root entry zone due to neurovascular conflict, which most often presents in the 6th decade of life. The authors report the case of a young patient with TN with a petrous apex bony spur near the entrance of Meckel\u2019s cave, causing compression of the proximal trigeminal nerve.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 21-year-old woman presented with a 5-year history of progressive right-sided TN. Axial T2 sampling perfection with application optimized contrast using different flip angle evolution magnetic resonance imaging (MRI) did not reveal vascular compression of the trigeminal nerve. However, sagittal reformats demonstrated a prominent bony ridge along the petrous apex, causing compression of the right trigeminal nerve at the porus trigeminus. Removal of the bony spur via a middle fossa approach completely resolved the patient\u2019s symptoms.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Although TN is most frequently caused by neurovascular compression, it is vital to examine the entire course of the trigeminal nerve on MRI to identify alternative causes of nerve compression in the absence of neurovascular conflict. Bony compression is a rare cause of TN that should be considered, particularly in younger patients. The presence of prominent osseous structures along the course of the trigeminal nerve can be evaluated reliably on sagittal MRI.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24321<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24321","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T01:44:44Z","timestamp":1731894284000},"source":"Crossref","is-referenced-by-count":1,"title":["Middle fossa approach for a petrous apex bony spur causing trigeminal neuralgia: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Forrest","family":"Hamrick","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Colby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William T.","family":"Couldwell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shervin","family":"Rahimpour","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1-2","key":"bib1","series-title":"Pain","first-page":"156","article-title":"Epidemiology and treatment of neuropathic pain: the UK primary care perspective","volume":"122","author":"Hall","year":"2006","unstructured":"Hall GCCarroll DParry DMcQuay HJ. Epidemiology and treatment of neuropathic pain: the UK primary care perspective. Pain. 2006;122(1-2):156-162."},{"issue":"1-3","key":"bib2","series-title":"Pain","first-page":"122","article-title":"Incidence of facial pain in the general population","volume":"147","author":"Koopman","year":"2009","unstructured":"Koopman JSHADieleman JPHuygen FJde Mos MMartin CGMSturkenboom MCJM. Incidence of facial pain in the general population. Pain. 2009;147(1-3):122-127."},{"issue":"9","key":"bib3","series-title":"Lancet Neurol","first-page":"784","article-title":"Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia","volume":"19","author":"Bendtsen","year":"2020","unstructured":"Bendtsen LZakrzewska JMHeinskou TB, et al. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. 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Anat Histol Embryol. 2023;52(4):645-648."},{"key":"bib8","series-title":"World Neurosurg","first-page":"79","article-title":"Trigeminal neuralgia due to petrosal bone deformity","volume":"126","author":"Hirata","year":"2019","unstructured":"Hirata SKobayashi MKamamoto DKosugi KYoshida KFujimaki T. Trigeminal neuralgia due to petrosal bone deformity. World Neurosurg. 2019;126:79-82."},{"key":"bib9","series-title":"Ann Med Surg (Lond)","first-page":"102308","article-title":"Case report of unusual cause of trigeminal neuralgia: trigeminal neuralgia secondary to enlarged suprameatal tubercle","volume":"66","author":"Ibrahim","year":"2021","unstructured":"Ibrahim BMuhsen BANajera EBorghei-Razavi HAdada B. Case report of unusual cause of trigeminal neuralgia: trigeminal neuralgia secondary to enlarged suprameatal tubercle. 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MRI findings in trigeminal neuralgia without neurovascular compression: implications of petrous ridge and trigeminal nerve angles. Korean J Radiol. 2022;23(8):821-827."},{"issue":"10","key":"bib19","series-title":"AJNR Am J Neuroradiol","first-page":"1460","article-title":"Sagittal angle of the trigeminal nerve at the porus trigeminus: a novel measurement to distinguish different causes of classic trigeminal neuralgia","volume":"43","author":"Branstetter","year":"2022","unstructured":"Branstetter BFReddy NPatel KSekula R. Sagittal angle of the trigeminal nerve at the porus trigeminus: a novel measurement to distinguish different causes of classic trigeminal neuralgia. AJNR Am J Neuroradiol. 2022;43(10):1460-1463."},{"issue":"1-2","key":"bib1","series-title":"Pain","first-page":"156","article-title":"Epidemiology and treatment of neuropathic pain: the UK primary care perspective","volume":"122","author":"Hall","year":"2006","unstructured":"Hall GCCarroll DParry DMcQuay HJ. Epidemiology and treatment of neuropathic pain: the UK primary care perspective. Pain. 2006;122(1-2):156-162."},{"issue":"1-3","key":"bib2","series-title":"Pain","first-page":"122","article-title":"Incidence of facial pain in the general population","volume":"147","author":"Koopman","year":"2009","unstructured":"Koopman JSHADieleman JPHuygen FJde Mos MMartin CGMSturkenboom MCJM. Incidence of facial pain in the general population. Pain. 2009;147(1-3):122-127."},{"issue":"9","key":"bib3","series-title":"Lancet Neurol","first-page":"784","article-title":"Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia","volume":"19","author":"Bendtsen","year":"2020","unstructured":"Bendtsen LZakrzewska JMHeinskou TB, et al. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. 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World Neurosurg. 2016;95:208-213."},{"issue":"3","key":"bib6","series-title":"Acta Neurochir (Wien)","first-page":"605","article-title":"Transcranial segment of the trigeminal nerve: macro-\/microscopic anatomical study using sheet plastination","volume":"156","author":"Liang","year":"2014","unstructured":"Liang LDiao YXu QZhang M. Transcranial segment of the trigeminal nerve: macro-\/microscopic anatomical study using sheet plastination. Acta Neurochir (Wien). 2014;156(3):605-612."},{"issue":"4","key":"bib7","series-title":"Anat Histol Embryol","first-page":"645","article-title":"An unusual finding of the porus trigeminus: case report with histological findings","volume":"52","author":"Banerjee","year":"2023","unstructured":"Banerjee SIwanaga JDumont ASTubbs RS. An unusual finding of the porus trigeminus: case report with histological findings. Anat Histol Embryol. 2023;52(4):645-648."},{"key":"bib8","series-title":"World Neurosurg","first-page":"79","article-title":"Trigeminal neuralgia due to petrosal bone deformity","volume":"126","author":"Hirata","year":"2019","unstructured":"Hirata SKobayashi MKamamoto DKosugi KYoshida KFujimaki T. Trigeminal neuralgia due to petrosal bone deformity. World Neurosurg. 2019;126:79-82."},{"key":"bib9","series-title":"Ann Med Surg (Lond)","first-page":"102308","article-title":"Case report of unusual cause of trigeminal neuralgia: trigeminal neuralgia secondary to enlarged suprameatal tubercle","volume":"66","author":"Ibrahim","year":"2021","unstructured":"Ibrahim BMuhsen BANajera EBorghei-Razavi HAdada B. Case report of unusual cause of trigeminal neuralgia: trigeminal neuralgia secondary to enlarged suprameatal tubercle. Ann Med Surg (Lond). 2021;66:102308."},{"issue":"6","key":"bib10","series-title":"J Neurosurg","first-page":"1519","article-title":"Trigeminal neuralgia without neurovascular compression presents earlier than trigeminal neuralgia with neurovascular compression","volume":"123","author":"Ko","year":"2015","unstructured":"Ko ALLee ARaslan AMOzpinar AMcCartney SBurchiel KJ. Trigeminal neuralgia without neurovascular compression presents earlier than trigeminal neuralgia with neurovascular compression. J Neurosurg. 2015;123(6):1519-1527."},{"issue":"3","key":"bib11","series-title":"J Neurosurg","first-page":"532","article-title":"Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery","volume":"96","author":"Devor","year":"2002","unstructured":"Devor MGovrin-Lippmann RRappaport ZH. Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery. J Neurosurg. 2002;96(3):532-543."},{"issue":"6","key":"bib12","series-title":"J Neurosurg","first-page":"1144","article-title":"Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression","volume":"107","author":"Sindou","year":"2007","unstructured":"Sindou MLeston JDecullier EChapuis F. Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. J Neurosurg. 2007;107(6):1144-1153."},{"issue":"5","key":"bib13","series-title":"J Neurosurg","first-page":"1048","article-title":"Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression","volume":"122","author":"Ko","year":"2015","unstructured":"Ko ALOzpinar ALee ARaslan AMMcCartney SBurchiel KJ. Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression. J Neurosurg. 2015;122(5):1048-1057."},{"issue":"5","key":"bib14","series-title":"J Neurosurg","first-page":"1048","article-title":"Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression","volume":"120","author":"Lee","year":"2014","unstructured":"Lee AMcCartney SBurbidge CRaslan AMBurchiel KJ. Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression. J Neurosurg. 2014;120(5):1048-1054."},{"issue":"3","key":"bib15","series-title":"Brain","first-page":"555","article-title":"Trigeminal neuralgia\u2014hemifacial spasm\u2014Paget\u2019s disease: significance of this association","volume":"89","author":"Gardner","year":"1966","unstructured":"Gardner WJDohn DF. Trigeminal neuralgia\u2014hemifacial spasm\u2014Paget\u2019s disease: significance of this association. Brain. 1966;89(3):555-562."},{"issue":"2","key":"bib16","series-title":"Neurosurgery","first-page":"ONS63","article-title":"Management of petrous endostosis in posterior fossa procedures for trigeminal neuralgia","volume":"60","author":"Shenouda","year":"2007","unstructured":"Shenouda EFCoakham HB. Management of petrous endostosis in posterior fossa procedures for trigeminal neuralgia. Neurosurgery. 2007;60(2suppl 1):ONS63-ONS69."},{"issue":"5","key":"bib17","series-title":"Acta Neurochir (Wien)","first-page":"971","article-title":"Role of the petrous ridge and angulation of the trigeminal nerve in the pathogenesis of trigeminal neuralgia, with implications for microvascular decompression","volume":"160","author":"Brinzeu","year":"2018","unstructured":"Brinzeu ADumot CSindou M. Role of the petrous ridge and angulation of the trigeminal nerve in the pathogenesis of trigeminal neuralgia, with implications for microvascular decompression. Acta Neurochir (Wien). 2018;160(5):971-976."},{"issue":"8","key":"bib18","series-title":"Korean J Radiol","first-page":"821","article-title":"MRI findings in trigeminal neuralgia without neurovascular compression: implications of petrous ridge and trigeminal nerve angles","volume":"23","author":"Zhong","year":"2022","unstructured":"Zhong HZhang WSun SBie Y. MRI findings in trigeminal neuralgia without neurovascular compression: implications of petrous ridge and trigeminal nerve angles. Korean J Radiol. 2022;23(8):821-827."},{"issue":"10","key":"bib19","series-title":"AJNR Am J Neuroradiol","first-page":"1460","article-title":"Sagittal angle of the trigeminal nerve at the porus trigeminus: a novel measurement to distinguish different causes of classic trigeminal neuralgia","volume":"43","author":"Branstetter","year":"2022","unstructured":"Branstetter BFReddy NPatel KSekula R. Sagittal angle of the trigeminal nerve at the porus trigeminus: a novel measurement to distinguish different causes of classic trigeminal neuralgia. 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