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Vol. 28. Issue 5.
Pages 247-250 (September - October 2017)
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Vol. 28. Issue 5.
Pages 247-250 (September - October 2017)
Caso clínico
Neuralgia del trigémino secundaria a endostosis del hueso temporal
Trigeminal neuralgia secondary to petrous endostosis
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Jacinto Mata-Gómeza,
Corresponding author
jacinto.mata@gmail.com

Autor para correspondencia.
, Manuel Royano-Sáncheza, Macarena Bejarano-Parrab, Ignacio Gilete-Tejeroa, María Rico-Coteloa, Marta Ortega-Martíneza
a Servicio de Neurocirugía, Complejo Hospitalario Universitario de Cáceres, Cáceres, España
b Sección de Neurología, Hospital Virgen del Puerto, Plasencia, Cáceres, España
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Resumen

La compresión neurovascular de origen arterial se postula como principal mecanismo de producción de la neuralgia primaria del trigémino. A pesar de ser la causa más frecuente, existen otras patologías, como los tumores localizados en el ángulo pontocerebeloso, capaces de producir dolor trigeminal.

Presentamos el caso de una paciente de 44años con neuralgia del trigémino derecha sin respuesta al tratamiento médico. La RM cerebral previa no muestra signos de patología estructural. Durante la descompresión microvascular del nervio trigémino se encuentra endostosis de la cara interna del peñasco que provocaba compresión del v par. Tras el fresado completo y la descompresión microvascular desaparece de manera completa el dolor en el postoperatorio inmediato, manteniendo asintomática al año de la cirugía.

La endostosis del hueso temporal es una causa muy infrecuente de neuralgia del trigémino. Una adecuada revisión de los estudios preoperatorios permitiría la optimización del manejo quirúrgico definitivo.

Palabras clave:
Neuralgia del trigémino
Endostosis petrosa
Descompresión microvascular
Ángulo pontocerebeloso
Abordaje retrosigmoideo
Abstract

Arterial neurovascular compression is hypothesised to be the main cause of primary trigeminal neuralgia. Although it is the most common cause, other pathologies, such as tumours in the cerebellopontine angle, can cause trigeminal pain.

We report a case of a 44-year-old female patient with right trigeminal neuralgia without satisfactory response to medical treatment. Cerebral MRI showed no structural injuries. During microvascular decompression of the trigeminal nerve, endostosis of the internal aspect of the petrous bone was found to compress the trigeminal nerve. The pain disappeared completely in the early postsurgical period, after the complete drilling of the endostosis and microvascular decompression. The patient remains asymptomatic one year later.

Endostosis of the petrous bone is a rare cause of trigeminal neuralgia. A proper review of preoperative studies would enable the definitive surgical approach to be optimised.

Keywords:
Trigeminal neuralgia
Petrous endostosis
Microvascular decompression
Cerebellopontine angle
Retrosigmoid approach

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