02 June 2021
: Case report
Prophylactic Intra-Arterial Injection of Lidocaine Prevents Trigeminocardiac Reflex During Endovascular Embolization for Dural Arteriovenous Fistula: A Report of 2 Cases
Unusual clinical course, Unusual or unexpected effect of treatment
Zhaochu Sun1CE, Hua Lu2BD*, Youli Hu1ADOI: 10.12659/AJCR.930837
Am J Case Rep 2021; 22:e930837
Figure 3. Schematic illustration of the autonomic neural pathways and effectors activated as a consequence of trigeminal nerve stimulation trigged either by peripheral signals from ophthalmic, maxillary, and mandibular branches or central cerebral vascular stimulus (figure modified from Buchholz’s publication [18]). The central TCR, which was stimulated by DMSO/ Onyx injection in the central vessel, induces a strong depressive response by a reciprocal activation of the parasympathetic system and an inhibition of the sympathetic system (red symbols). The peripheral TCR, which was stimulated by DMSO/Onyx injection in the peripheral vessels, involves simultaneous co-activation of both autonomic limbs (blue symbols).