Abstract
Trigeminal neuralgia is a debilitating condition that often presents secondary to neurovascular compression of the trigeminal nerve. However, arteriovenous malformations (AVMs) involving the trigeminal nerve are exceedingly rare and represent a unique diagnostic challenge. This report describes the case of a 54-year-old man presenting with severe, paroxysmal facial pain consistent with trigeminal neuralgia as the first manifestation of a cranial nerve V AVM. Radiological evaluation, including advanced magnetic resonance imaging (MRI), was pivotal in identifying the AVM. This case highlights the importance of comprehensive imaging in patients with atypical neuralgia to exclude rare but significant causes like AVMs.