Trigeminal neuralgia (TN) caused by venous compression presents challenges in surgical management, unlike the arterial type. Preoperative diagnostic certainty regarding venous etiology and anatomical relationships is crucial for surgical success. We discuss a case of TN caused by a vein passing through the nerve that was challenging to visualize on conventional MRI and was treated successfully by leveraging information from modern surgical simulation technology with 3D computer graphics. We recognized a potentially troublesome anatomical feature in advance and mitigated the risk by identifying a collateral drainage route for the causative vein, making it feasible to be sacrificed while ensuring treatment efficacy.
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Kanayama et al. (2024) studied this question.
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