Trigeminal neuralgia caused by dual compressive pathology of developmental venous anomaly and small enhancing lesion

Trigeminal neuralgia (TN) is a debilitating chronic pain disorder characterized by hemifacial lancinating pain originating from the trigeminal nerve. TN is the most common disorder in the broad category of neurovascular compression syndromes (NVCS). A developmental venous anomaly (DVA) causing symptomatic compression of the trigeminal nerve is a rarely reported entity with most cases being effectively treated with microvascular decompression (MVD). Similarly, both benign and malignant neoplasms resulting in symptomatic compression of the trigeminal nerve are known entities that are frequently treated with a combination of conservative management, radiosurgery, rhizotomy, or surgery. We describe here a case of trigeminal neuralgia caused by both DVA and a small enhancing neoplasm. According to our knowledge and literature review, this is the first case of TN caused by such a dual compressive pathology. Keywords: Trigeminal neuralgia, Microvascular decompression, MVD, Rhizotomy, Neurovascular compression, Pai