Tumor associated trigeminal neuralgia [Neurosurgery Wiki]

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====== Tumor associated trigeminal neuralgia ======

{{ ::tumor_associated_trigeminal_neuralgia.jpg?400|}}
[[Trigeminal neuralgia pathogenesis]] is uncertain. What is nominated as typically TN is [[idiopathic]], but may be due to a structural lesion:

[[Posterior fossa tumor]]s
((Deshmukh VR, Hott JS, Tabrizi P, Nakaji P, Feiz-Erfan I, Spetzler RF. Cavernous malformation of the trigeminal nerve manifesting with trigeminal neuralgia: Case report. Neurosurgery. 2005;56:E623.))
((Deshpande S, Kaptain GJ, Pobereskin LH. Temporal glioblastoma causing trigeminal neuralgia. J Neurosurg. 1999;91:515.))
((Gnanalingham K, Joshi SM, Lopez B, Ellamushi H, Hamlyn P. Trigeminal neuralgia secondary to Chiari's malformation--treatment with ventriculoperitoneal shunt. Surg Neurol. 2005;63:586–8. discussion 588-9.))
((Goel A, Sham A. Trigeminal neuralgia in the presence of ectatic basilar artery and basilar invagination: Treatment by foramen magnum decompression: Case report. J Neurosurg. 2009;111:1220–2.))
((Peñarrocha-Diago M, Mora-Escribano E, Bagán JV, Peñarrocha-Diago M. Neoplastic trigeminal neuropathy: Presentation of 7 cases. Med Oral Patol Oral Cir Bucal. 2006;11:E106–11.)),
contralateral posterior fossa tumors,
((Deshmukh VR, Hott JS, Tabrizi P, Nakaji P, Feiz-Erfan I, Spetzler RF. Cavernous malformation of the trigeminal nerve manifesting with trigeminal neuralgia: Case report. Neurosurgery. 2005;56:E623.))
((Goel A, Sham A. Trigeminal neuralgia in the presence of ectatic basilar artery and basilar invagination: Treatment by foramen magnum decompression: Case report. J Neurosurg. 2009;111:1220–2.))
ipsilateral and contralateral [[supratentorial tumor]]s
((Cirak B, Kimaz N, Arslanoglu A. Trigeminal neuralgia caused by intracranial epidermoid tumor: Report of a case and review of different therapeutic modalities. Pain Physician. 2004;7:129–32.))
((Deshpande S, Kaptain GJ, Pobereskin LH. Temporal glioblastoma causing trigeminal neuralgia. J Neurosurg. 1999;91:515.))
((Goel A, Sham A. Trigeminal neuralgia in the presence of ectatic basilar artery and basilar invagination: Treatment by foramen magnum decompression: Case report. J Neurosurg. 2009;111:1220–2.))
((Guttal KS, Naikmasur VG, Joshi SK, Bathi RJ. Trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle: Case report and brief review. Odontology. 2009;97:54–6.))
((Love S, Coakham HB. Trigeminal neuralgia: Pathology and pathogenesis. Brain. 2001;124:2347–60.)).

Trigeminal neuralgia in [[vestibular schwannoma]]
((Apostolakis S, Karagianni A, Mitropoulos A, Filias P, Vlachos K. Trigeminal
neuralgia in vestibular schwannoma: Atypical presentation and neuroanatomical
correlations. Neurochirurgie. 2019 Mar 21. pii: S0028-3770(19)30024-4. doi:
10.1016/j.neuchi.2019.01.001. [Epub ahead of print] PubMed PMID: 30905383.
)).

Trigeminal neuralgia as the initial manifestation of temporal glioma
((Khalatbari M, Amirjamshidi A. Trigeminal neuralgia as the initial
manifestation of temporal glioma: Report of three cases and a review of the
literature. Surg Neurol Int. 2011;2:114. doi: 10.4103/2152-7806.83734. Epub 2011 
Aug 13. PubMed PMID: 21886887; PubMed Central PMCID: PMC3162802.
)).

A supratentorial tumor can initiate TN even without a direct involvement of the trigeminal ganglion or nerve. Such tumors may lead to increased [[intracranial pressure]] and brain [[shift]] generating a pressure cone that distorts the [[brain stem]] and displaces an adjacent vessel, compressing the trigeminal nerve root.

Another explanatory mechanism in a patient with supratentorial tumor and hydrocephalus can be that pressure over the trigeminal sensory root rather than stretching of the nerve fiber leads to TN
((Cirak B, Kimaz N, Arslanoglu A. Trigeminal neuralgia caused by intracranial epidermoid tumor: Report of a case and review of different therapeutic modalities. Pain Physician. 2004;7:129–32. )).

===== References =====