02 June 2021>: Articles
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 treatmentZhaochu Sun C , Hua Lu B , Youli Hu A*
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 ). 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).