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Understanding Trigeminal Neuralgia: A Comprehensive Review of Symtoms, Diagnosis, and Management Valentino, Andrea; Mardhiyah, Farah; Maspian Tjili, Tondi; Hadisi, Anthar; Aji Prihartomo, Gatot; Prastya Pardede, Jeremia; Wirdayanto, Ade
Journal of International Surgery and Clinical Medicine Vol. 4 No. 2 (2024): (Available online: 1 December 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i2.62

Trigeminal neuralgia (tic douloureux) is a rare and debilitating facial pain condition affecting one or more branches of the trigeminal nerve. It is frequently misdiagnosed as a dental issue or temporomandibular disorder due to overlapping symptoms, delaying appropriate treatment. Diagnosis is primarily clinical, often requiring the expertise of a neurologist to distinguish it from other causes of facial pain. Imaging studies such as MRI or CT scans are not diagnostic but play a crucial role in ruling out secondary causes and identifying pathological changes in the affected nerve root. Although not life-threatening, trigeminal neuralgia significantly impacts the quality of life, causing severe, recurrent pain episodes that can be challenging to manage. Timely and accurate diagnosis, along with the implementation of effective therapeutic strategies, is essential to alleviate symptoms and improve patient outcomes. This review highlights the clinical presentation, diagnostic approach, and current treatment modalities for trigeminal neuralgia, emphasizing the importance of a multidisciplinary approach to care.

Intraventricular Meningioma: A Case Series Valentino, Andrea; Wahyudi; Prastya Pardede, Jeremia; Maspian Tjili , Tondi; Hadisi, Anthar; Aji Prihartomo, Gatot; Wirdayanto, Ade; Rangkuti, Ina Farida
Journal of International Surgery and Clinical Medicine Vol. 4 No. 2 (2024): (Available online: 1 December 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i2.61

Introduction: Intraventricular meningiomas account for approximately 1.5% of meningiomas, 80% of these were localized in the lateral ventricles, 15% in the third ventricle (mostly in the ventricle trigone), and the remaining 5% in the fourth ventricle. This case report aims to highlight clinical findings and difficulty on removal of the tumor intraoperatively. Case description: We presented 2 cases of Intraventricular Meningioma. Both patient have a chief complaint of chronic headache since 2 years ago. Through the magnetic resonance imaging examination, we found a solid mass at right ventricle trigone with enhance homogenously 7.3 x 5.5 x 6.5 cm on the first patient and 6.8 x 8.4 x 3.2 cm on the second patient. Both patients went through craniotomy tumor removal. The pathology showed a Transitional Meningioma who grade I and KI-67 immunohistochemical staining result: 1-2 % on the first patien and angiomatous meningioma (WHO grade 1) on the second patient. Both patients showed improvement post-surgery Conclusion: We have successfully performed a total craniotomy tumor removal on the right trigone intraventricular meningioma. However, the primary challenge lies in excising intraventricular meningiomas located in the trigone without causing injury to the geniculocalcarine tracts. Therefore, the surgical approach must be carefully planned based on the tumor's location and intraoperative monitoring as well as surgical strategy to avoid the neurological deficits.

Navigating Surgical Strategies for Symptomatic Tarlov Cysts: A Case Report of Successful Microsurgical Excision and Imbrication Arip Heru Tripana; Tondi Maspian Tjili; Afdal; Ismar; Eko Setiawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1413

Background: Symptomatic Tarlov (perineural) cysts are a rare but debilitating cause of chronic radicular pain, arising from cerebrospinal fluid (CSF) accumulation within the nerve root sheath. The diagnostic journey is often complex, requiring a definitive link between the lesion and the patient's symptoms, and the optimal surgical strategy remains a subject of considerable debate. Case presentation: A 56-year-old male presented with a six-month history of intractable right S2 radiculopathy (VAS 8/10) and severe functional impairment (Oswestry Disability Index 78%), which had failed a comprehensive trial of conservative management. Magnetic resonance imaging revealed a large cystic lesion at the right S2 level, with features characteristic of a Tarlov cyst, causing severe nerve root compression. Following a thorough discussion of the risks and benefits, the patient underwent an S2 laminectomy with microsurgical partial cyst excision and wall imbrication. Postoperative histopathology confirmed the diagnosis of a perineural cyst, identifying nerve fibers within the fibroconnective tissue of the cyst wall. Conclusion: The patient experienced immediate and sustained resolution of his radicular pain (VAS 0/10) and a profound improvement in functional status (ODI 12%) at one-year follow-up, with radiological confirmation of successful cyst obliteration. This case highlights the potential of a direct microsurgical approach, guided by a strong clinical-radiological correlation and confirmed by histopathology, to provide a durable and life-altering cure for patients disabled by symptomatic Tarlov cysts.

Navigating Surgical Strategies for Symptomatic Tarlov Cysts: A Case Report of Successful Microsurgical Excision and Imbrication Arip Heru Tripana; Tondi Maspian Tjili; Afdal; Ismar; Eko Setiawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1413

Background: Symptomatic Tarlov (perineural) cysts are a rare but debilitating cause of chronic radicular pain, arising from cerebrospinal fluid (CSF) accumulation within the nerve root sheath. The diagnostic journey is often complex, requiring a definitive link between the lesion and the patient's symptoms, and the optimal surgical strategy remains a subject of considerable debate. Case presentation: A 56-year-old male presented with a six-month history of intractable right S2 radiculopathy (VAS 8/10) and severe functional impairment (Oswestry Disability Index 78%), which had failed a comprehensive trial of conservative management. Magnetic resonance imaging revealed a large cystic lesion at the right S2 level, with features characteristic of a Tarlov cyst, causing severe nerve root compression. Following a thorough discussion of the risks and benefits, the patient underwent an S2 laminectomy with microsurgical partial cyst excision and wall imbrication. Postoperative histopathology confirmed the diagnosis of a perineural cyst, identifying nerve fibers within the fibroconnective tissue of the cyst wall. Conclusion: The patient experienced immediate and sustained resolution of his radicular pain (VAS 0/10) and a profound improvement in functional status (ODI 12%) at one-year follow-up, with radiological confirmation of successful cyst obliteration. This case highlights the potential of a direct microsurgical approach, guided by a strong clinical-radiological correlation and confirmed by histopathology, to provide a durable and life-altering cure for patients disabled by symptomatic Tarlov cysts.

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