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Primary brain stem tethering: a rare cause of geniculate neuralgia

Published online by Cambridge University Press:  29 June 2007

Geert G. Buyse ,
Jo Caekebeke ,
Philippe Demaerel  and
Chris Plets
Geert G. Buyse*
Affiliation:
Departments of Neurosurgery, University Hospital Gasthuisberg, Leuven, Belgium.
Jo Caekebeke
Affiliation:
Department of Neurologyt, Onze Lieve Vrouw Hospital, Aalst, Belgium.
Philippe Demaerel
Affiliation:
Departments of Radiology, University Hospital Gasthuisberg, Leuven, Belgium.
Chris Plets
Affiliation:
Departments of Neurosurgery, University Hospital Gasthuisberg, Leuven, Belgium.
*
Address for correspondence: Geert G. Buyse, Department of Neurosurgery, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. Fax: 00 32 16 34 42 85
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Abstract

This rare case of brain stem tethering presented with chronic and progressive geniculate neuralgia. In view of the fact that an occipital subcutaneous lipoma had been resected in childhood, it probably concerned a primary tethering, fitting in with an occult occipital dysraphism.

Magnetic resonance imaging (MRI) clearly demonstrated an underlying tethering, causing a distortion of the brain stem. Consequently, this led to the hypothesis that the geniculate neuralgia could be explained by traction on the lower cranial nerves secondary to the brain stem displacement. Untethering resulted in a considerable decrease of the neuralgia.

MRI proved to be essential in the diagnosis and treatment of this unusual case.

Keywords

Geniculate ganglionNeuralgia
Type
Radiology in focus
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 10 , October 1999 , pp. 945 - 947
Copyright
Copyright © JLO (1984) Limited 1999

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