Secondary trigeminal neuralgia caused by vertebrobasilar dolichoectasia treated with flow-diverting stent reconstruction: a case report.

Abstract

Vertebrobasilar dolichoectasia (VBD) is a rare clinical condition that occasionally causes secondary trigeminal neuralgia through compression of the trigeminal nerve. Reported treatment methods include oral carbamazepine, microvascular decompression, percutaneous balloon compression, and gamma knife radiosurgery; however, outcomes are often limited, and symptom recurrence is common. Moreover, many of these therapeutic approaches are associated with significant adverse effects. In June 2025, a 66-year-old man presented with VBD-induced secondary trigeminal neuralgia. His diagnosis was confirmed through imaging and clinical studies upon admission. The patient was treated by placing a flow-diverting stent in one vertebrobasilar artery and occluding the contralateral vertebral artery, to reconstruct the blood flow and reduce compression of the trigeminal nerve. The surgical outcome was favorable, with no painful attacks and a visual analogue scale pain score of 0 by postoperative Day 6.