Atheromatous plaque formation in a man with high-risk atherosclerosis after Gamma Knife stereotactic radiosurgery for trigeminal neuralgia

Cho-Shun Li^{a, b, c}, Jung-Tung Liu^{a, b, c}, Cheng-Siu Chang^{a, b, c}, Wen-Jui Liao^{a, b, c}

^a School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
^b Department of Medical Education, Chung-Shan Medical University Hospital, Taichung, Taiwan
^c Department of Neurosurgery, Chung-Shan Medical University Hospital, Taichung, Taiwan

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Abstract

We report a rare case of atheromatous plaque formation in the offending parent artery of a 39-year-old man 11 months after Gamma Knife stereotactic radiosurgery (GKSR) for trigeminal neuralgia (TN). Focal atheromatous changes to the parent vessel remote from the root entry zone (REZ) of the trigeminal nerve were discovered during rescue open surgery; this has seldom been reported. Our report suggests that younger male TN patients with hyperlipidemia who receive GKSR may have an increased risk of post-radiation atheromatous formation. A review of the literature is carried out together with a discussion of the possible mechanism by which this complication occurred.

Keywords

Atheromatous plaque; Gamma Knife radiosurgery; Microvascular decompression; Trigeminal neuralgia