biostudies-literatureUnknown16Gallegos Pedraza AAn enlarged suprameatal tubercle (EST) has been described as an uncommon anatomical variant that may be encountered during cerebellopontine angle surgery. It can limit exposure during microvascular decompression (MVD) of the trigeminal nerve, particularly when the neurovascular conflict is located distal to the root entry zone (REZ), potentially posing a surgical challenge. We present the case of a 66-year-old woman with a history of medically refractory left-sided V2-V3 typical trigeminal neuralgia, previously treated with radiofrequency ablation without clinical improvement. Magnetic resonance imaging (fast imaging employing steady-state acquisition sequence) demonstrated a vascular loop compressing the left trigeminal nerve. A left retrosigmoid craniotomy was performed. Initial exploratSurgical neurology international276https://www.ebi.ac.uk/biostudies/studies/S-EPMC12361673biostudies-literatureEnlarged suprameatal tubercle drilling for distal venous microvascular decompression of the trigeminal nerve, anatomical description: Two-dimensional video.PMC12361673Gallegos Pedraza ABaldoncini MOrdonez-Rubiano EGCampero AAldhfyan YMMontes de Oca Delgado MEchavarria Demichelis MfalseEnlarged suprameatal tubercle drilling for distal venous microvascular decompression of the trigeminal nerve, anatomical description: Two-dimensional video.An enlarged suprameatal tubercle (EST) has been described as an uncommon anatomical variant that may be encountered during cerebellopontine angle surgery. It can limit exposure during microvascular decompression (MVD) of the trigeminal nerve, particularly when the neurovascular conflict is located distal to the root entry zone (REZ), potentially posing a surgical challenge. We present the case of a 66-year-old woman with a history of medically refractory left-sided V2-V3 typical trigeminal neuralgia, previously treated with radiofrequency ablation without clinical improvement. Magnetic resonance imaging (fast imaging employing steady-state acquisition sequence) demonstrated a vascular loop compressing the left trigeminal nerve. A left retrosigmoid craniotomy was performed. Initial explorat2025-01-01T00:00:00Z20252026-04-08T03:51:20.888Z2026-04-07T21:41:57.873ZS-EPMC123616734083731510.25259/SNI_288_2025