Venous sinus stenting for cerebral venous congestion-induced trigeminal neuralgia: A case report

Abstract

Background

Uncommon clinical manifestations of cerebral venous congestion syndrome (CVCS) are challenging for clinicians and may result in inappropriate treatment selection and incomplete clinical resolution. Although trigeminal neuralgia (TN) has been reported in association with CVCS, evidence of symptom resolution following venous sinus stenting (VSS) is lacking. We report a case in which VSS effectively alleviated TN.

Case Presentation

A middle-aged female patient presented with bilateral pulsatile tinnitus, papilledema, pressure headaches, as well as left-sided TN. Initial computerized tomography venography demonstrated bilateral transverse sinus stenosis and a prominent left mastoid emissary vein. Therefore, VSS was offered. Venous pressure measurements for extra- and intracranial veins were acquired, revealing a pressure gradient. Successful bilateral transverse sinus stenting was performed, resulting in a reduction of the pressure gradient in both sinuses. Endovascular stenting proved effective in managing CVCS symptomatology, including CVCS-induced TN. Residual left-sided pulsatile tinnitus due to the left mastoid emissary vein persisted.

Conclusion

This case underscores the role of intracranial VSS in managing CVCS-associated symptoms, demonstrating its potential to relieve both typical and less common manifestations, including TN.