A 52-year-old woman has paroxysmal lancinating pain in the right cheek lasting seconds, triggered by chewing, with no sensory loss or corneal reflex abnormality. Carbamazepine controls her pain initially. MRI angiography shows a vessel abutting the root entry zone of the trigeminal nerve. Which vessel is the usual offender at this site?

• A Anterior inferior cerebellar artery
• B Basilar artery trunk
• C Posterior inferior cerebellar artery
• D Superior cerebellar artery ✓

Explanation

Trigeminal neuralgia is classically caused by vascular compression at the dorsal root entry zone of the fifth nerve near the pons, and the superior cerebellar artery is the offending vessel in the majority of cases. Microvascular decompression offers durable relief when drugs fail or cause intolerance. The anterior inferior cerebellar artery more often compresses the facial nerve at its root exit zone causing hemifacial spasm, and the PICA relates to glossopharyngeal neuralgia, which eliminates these distractors.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.