Posterior petrous meningioma with secondary trigeminal neuralgia: microsurgical resection after stereotactic radiosurgery (case report and literature review)

Gordienko K.S.

Saint-Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-0720-2217

Trashin A.V.

Saint-Petersburg City Multi-field Hospital No. 2;
Mechnikov North-Western State Medical University

ORCID: 0000-0003-4770-3400

Stepanenko V.V.

Saint-Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-1881-2088

Shulev Yu.A.

Saint-Petersburg City Multi-field Hospital No. 2;
Mechnikov North-Western State Medical University

ORCID: 0000-0002-0696-0200

Posterior petrous meningioma with secondary trigeminal neuralgia: microsurgical resection after stereotactic radiosurgery (case report and literature review)

Authors:

Gordienko K.S., Trashin A.V., Stepanenko V.V., Shulev Yu.A.

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Journal: Burdenko's Journal of Neurosurgery. 2024;88(4): 85‑91

DOI: 10.17116/neiro20248804185

Downloaded: 34

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To cite this article:

Gordienko KS, Trashin AV, Stepanenko VV, Shulev YuA. Posterior petrous meningioma with secondary trigeminal neuralgia: microsurgical resection after stereotactic radiosurgery (case report and literature review). Burdenko's Journal of Neurosurgery. 2024;88(4):85‑91. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248804185

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

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According to the literature, cerebellopontine angle tumors cause secondary trigeminal neuralgia and other symptoms of neurovascular compression in 1—9.9% of cases. We present a 58-year-old patient with left-sided secondary trigeminal neuralgia caused by ipsilateral posterior petrous meningioma. Stereotactic irradiation was followed by effective tumor growth control. However, residual trigeminal pain paroxysms significantly reduced the quality of life and required subsequent microsurgery. Trigeminal facial pain regressed after total resection of tumor. Considering this clinical case, we would like to discuss several issues: follow-up of meningioma requiring radiosurgery, course of secondary trigeminal neuralgia in a patient with apical petrous meningioma, characteristics of pain before and after radiosurgery, the best treatment option for these patients. Stereotactic radiosurgery seems unreasonable for CPA tumors with secondary trigeminal neuralgia. Indeed, persistent pain is possible even after tumor shrinkage. Moreover, primary stereotactic irradiation significantly complicates subsequent resection of tumor.

Keywords:

neurovascular compression syndromes

posterior petrous meningioma

CPA meningioma

secondary trigeminal neuralgia

secondary hemifacial spasm

Authors:

Gordienko K.S.

Saint-Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-0720-2217

Trashin A.V.

Saint-Petersburg City Multi-field Hospital No. 2;
Mechnikov North-Western State Medical University

ORCID: 0000-0003-4770-3400

Stepanenko V.V.

Saint-Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-1881-2088

Shulev Yu.A.

Saint-Petersburg City Multi-field Hospital No. 2;
Mechnikov North-Western State Medical University

ORCID: 0000-0002-0696-0200

Received:

04.04.2024

Accepted:

31.05.2024

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