Stereotactic radiosurgery is a treatment option for trigeminal neuralgia. This procedure is minimally invasive, but tumor development and facial numbness have been reported. Here, we report an unusual presentation after stereotactic radiosurgery to treat trigeminal neuralgia. A 60-year-old man demonstrated typical signs for type 1 trigeminal nerve neuralgia and was treated with medication for 5 years. Owing to an intolerance to that medication, he received stereotactic radiosurgery with 66 Gy. During a 9-year follow-up exam, dizziness with a spinning sensation was reported and a right superior cerebellar thrombosed aneurysm was diagnosed. He received transarterial embolization with coiling of aneurysm and subsequently reported no complications on follow-up exams. Although stereotactic radiosurgery is a promising treatment for trigeminal neuralgia, aneurysm development may be considered a possible complication. Long-term follow-up care of these patients should be considered. To understand the relationship between radiosurgery and the potential development of a cerebral aneurysm, further research is needed.

1.
Nanney
AD
 III
,
El Tecle
NE
,
El Ahmadieh
TY
,
Daou
MR
,
Bit Ivan
EN
,
Marymont
MH
, et al.
Intracranial aneurysms in previously irradiated fields: literature review and case report
.
World Neurosurg
.
2014
;
81
(
3–4
):
511
9
. .
2.
Jurado
JA
,
Bashir
R
,
Burket
MW
.
Radiation-induced peripheral artery disease
.
Catheter Cardiovasc Interv
.
2008
;
72
(
4
):
563
8
. .
3.
Spina
A
,
Mortini
P
,
Alemanno
F
,
Houdayer
E
,
Iannaccone
S
.
Trigeminal neuralgia: toward a multimodal approach
.
World Neurosurg
.
2017
;
103
:
220
30
. .
4.
Gronseth
G
,
Cruccu
G
,
Alksne
J
,
Argoff
C
,
Brainin
M
,
Burchiel
K
, et al.
Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies
.
Neurology
.
2008
;
71
(
15
):
1183
90
. .
5.
Zhang
X
,
Ares
WJ
,
Taussky
P
,
Ducruet
AF
,
Grandhi
R
.
Role of matrix metalloproteinases in the pathogenesis of intracranial aneurysms
.
Neurosurg Focus
.
2019
;
47
(
1
):
E4
. .
6.
Akai
T
,
Torigoe
K
,
Fukushima
M
,
Iizuka
H
,
Hayashi
Y
.
De novo aneurysm formation following gamma knife surgery for arteriovenous malformation: a case report
.
J Neurol Surg Rep
.
2015
;
76
(
1
):
e105
8
. .
7.
Schievink
WI
,
Wijdicks
EF
,
Piepgras
DG
,
Chu
CP
,
O’Fallon
WM
,
Whisnant
JP
.
The poor prognosis of ruptured intracranial aneurysms of the posterior circulation
.
J Neurosurg
.
1995
;
82
(
5
):
791
5
. .
8.
Uchikawa
H
,
Nishi
T
,
Kaku
Y
,
Goto
T
,
Kuratsu
JI
,
Yano
S
.
Delayed development of aneurysms following gamma knife surgery for trigeminal neuralgia: report of 2 cases
.
World Neurosurg
.
2017
;
99
:
813
e19
. .
9.
Pak
S
,
Cha
D
,
Valencia
D
,
Askaroglu
Y
,
Short
J
,
Bouz
P
.
Pseudoaneurysm as a late complication of gamma knife surgery for trigeminal neuralgia
.
Neurol India
.
2018 Mar–Apr
;
66
(
2
):
514
5
. .
10.
Huang
PP
,
Kamiryo
T
,
Nelson
PK
.
De novo aneurysm formation after stereotactic radiosurgery of a residual arteriovenous malformation: case report
.
AJNR Am J Neuroradiol
.
2001
;
22
(
7
):
1346
8
.
11.
Takao
T
,
Fukuda
M
,
Kawaguchi
T
,
Nishino
K
,
Ito
Y
,
Tanaka
R
, et al.
Ruptured intracranial aneurysm following gamma knife surgery for acoustic neuroma
.
Acta Neurochir
.
2006
;
148
(
12
):
1317
8
.
discussion 1318
. .
12.
Akamatsu
Y
,
Sugawara
T
,
Mikawa
S
,
Saito
A
,
Ono
S
,
Takayama
K
, et al.
Ruptured pseudoaneurysm following gamma Knife surgery for a vestibular schwannoma
.
J Neurosurg
.
2009
;
110
(
3
):
543
6
. .
13.
Park
KY
,
Ahn
JY
,
Lee
JW
,
Chang
JH
,
Huh
SK
.
De novo intracranial aneurysm formation after gamma Knife radiosurgery for vestibular schwannoma
.
J Neurosurg
.
2009
;
110
(
3
):
540
2
. .
14.
Sunderland
G
,
Hassan
F
,
Bhatnagar
P
,
Mitchell
P
,
Jayakrishnan
V
,
Forster
D
, et al.
Development of anterior inferior cerebellar artery pseudoaneurysm after gamma knife surgery for vestibular schwannoma. A case report and review of the literature
.
Br J Neurosurg
.
2014
;
28
(
4
):
536
8
. .
15.
Kellner
CP
,
McDowell
MM
,
Connolly
ES
,
Sisti
MB
,
Lavine
SD
.
Late onset aneurysm development following radiosurgical obliteration of a cerebellopontine angle meningioma
.
BMJ Case Rep
.
2014
;
2014
.
bcr2014011206
. .
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