• Ehtisham Ahmed Khan Afridi
  • Shahbaz Ali Khan
  • Waqar -ur-Rehman Qureshi
  • Sajid Nazir Bhatti
  • Gul Muhammad
  • Shakir Mahmood
  • Abdur Rehman


Background: Though the classical type of trigeminal neuralgia is the most common type with the neurovascular conflict causing the symptoms, yet quite some patients have the secondary type of trigeminal neuralgia in which space occupying lesions are responsible for the symptoms. This study was conducted to determine the frequency of cerebellopontine angle tumours in patients presenting with complaints of trigeminal neuralgia. Methods: This case series descriptive study was conducted in the department of Neurosurgery, Ayub Medical College, Abbottabad, from January 2009 to January 2012. It included patients who presented with symptoms of trigeminal neuralgia. Patients were subjected to further radiological investigation like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) to look for secondary causes of trigeminal neuralgia. Results: Among the 134 patients with age ranges 13-64 (51±4.3) years of age, 78(58.2%) were females and 56 (41.7%) were males. Frequency of cerebellopontine angle tumours in patients was 14 (10.4%), among them epidermoid was most common lesion being present in 10 (7.4%) of patients and accounted for 75% of Cerebellopontine Angle tumours in these patients. Meningioma and vestibular schwanoma accounted for 2(1.4%) cases each. In secondary trigeminal neuralgia mean age of onset of symptoms was 39.5±5.2 years as compared to classic trigeminal neuralgia which is 53±2.1 years. Conclusion: Trigeminal Neuralgia can be a typical symptom in cerebellopontine angle tumours like epidermoid, especially in young patients, so all the patients with trigeminal neuralgia should be investigated for lesion in cerebellopontine region.Keywords: Trigeminal Neuralgia, Cerebellopontine Angle Tumours


Jellish WS, Benedict W, Owen K, Anderson D, Fluder E, Shea JF. Perioperative and long-term operative Outcomes after surgery for Trigeminal Neuralgia: Microvascular Decompression versus Percutaneous Ballon Ablation. Head Face Med 2008;4:11.

Emril DR, Ho KY. Treatment of Trigeminal Neuralgia: Role of Radiofrequency ablation. J Pain Res 2010;3:249–54.

Shulev Y, Trashin A, Gordienko K. Secondary Trigeminal Neuralgia in Cerebellopontine Angle Tumours. Skull Base 2011;21:287–94.

Love S, Coakham HB. Trigeminal Neuralgia: Pathology and Pathogenesis. Brain 2001;124(Part 12):2347–60.

Devor M, Govrin-Lippmann R, Rappaport ZH. Mechanism of Trigeminal Neuralgia: an ultrastructural analysis of Trigeminal root specimens obtained during Microvascular Decompression surgery. J Neurosurg 2002;96:532–43.

Son DW, Chori CH, Cha SH. Epidermoid tumours in the Cerebellopontine Angle presenting with Trigeminal neuralgia. J Koreon Neurosurg Soc 2010;47:271–7.

Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(Suppl 1):9–160.

Forbes J, Cooper C, Jermakowicz W, Neinat J, Konrad P. Microvascular decompression: salient surgical principles and technical Nuances. J Vis Exp. 2011;53:e2590.

Janneta PJ. Arterial Compression of the Trigeminal Nerve at the Pons in Patients with Trigeminal Neuralgia. J. Neurosurg 1967;26:159–62.

Zhang L, Zhang Y, Li C, Zhu S. Surgical Treatment of primary trigeminal neuralgia: Comparison of the effectiveness between MVD and MVD+PSR in a sereies of 210 patients. Turkish Neurosurgery 2012;22:32–8.

Cruccu G, Leandri M, Feliciani M, Manfredi M. Idiopathetic and symptomatic trigeminal pain. J Neurol Neurosurg Psychiatry 1990;53:1034–42.

Barker FG 2nd, Jannetta PJ, Babu RP, Pomonis S, Bissonate DJ, Jho HD. Long-Term Outcome after operation for trigeminal neuralgia in patients with posterior fossa tumours. J Neurosurg 1996;84:818–25.

Kobata H, Kondo A, Iwasaki K. Cerebellopontine angle Epidermoids presenting with cranial nerve hyperactive dysfunction: Pathogenesis and long-term surgical results in 30 patients. Neurosurgery 2002;50:276–85.

Kato K, Ujiie H, Higa T, Hayashi M, Kubo O, Okada Y, et al. Clinical presentation of intracranial epidermoids: a surgical series of 20 initial and four recurred cases. Asian J Neurosurg. 2010;5(1):32–40.

Matsuka Y, Fort ET, Merrill RL. Trigeminal neuralgia due to an acoustic neuroma in the cerebellopontine angle. J Orofac Pain. 2000;14:147–51.

Jamjoom AB, Jamjoom ZA, al-Fehaily M, el-Watidy S, al-Moallem M, Nain-Ur-Rahman. Trigeminal neuralgia related to cerebellopontine angle tumours. Neurosurg Rev. 1996;19:237–41.



Most read articles by the same author(s)

1 2 3 4 5 6 > >>