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A 33-year-old Vietnamese man with a history of superior sagittal sinus thrombosis secondary to tuberculous meningitis presented with severe recurrent trigeminal neuralgia. A complex compensatory cerebral venous drainage system developed, and a varix, in direct contact with the root entry zone of the trigeminal nerve, was the trigger for his pain. The patient's symptoms are presently controlled with a combination of medications for neuropathic pain, however he continues to experience frequent severe exacerbations and may very well require more invasive means to manage his condition in future.

Venous sinus thrombosis secondary to tuberculous meningitis: a novel cause of trigeminal neuralgia