Articles: microvascular-decompression-surgery.
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The risks and benefits of coagulating intradural venous elements during a retrosigmoid approach for trigeminal neurovascular decompression has not been accurately established. The objectives of this study were to identify the veins that drain into the superior petrosal sinus, classify them in relation to the suprameatal tubercle, and determine the implication of their coagulation. ⋯ The venous elements identified in trigeminal neurovascular decompressive surgery are variable. We propose classifying them into retromeatal, meatal, and premeatal groups. Retromeatal and meatal veins can be safely sacrificed for appropriate visualization of the neurovascular conflict. The premeatal venous elements should be coagulated only in justified cases.
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Case Reports
Microvascular Decompression through Cyanoacrylate Glue-Coated Teflon Sling Transposition Technique.
Vertebral artery dolichoectasia may produce a variety of clinical scenarios depending on the level of compression of several nervous structures along its course. Despite the fact that the pathophysiology is not fully clarified, it would seem that this pathologic elongation and dilation of the artery are acquired and determined by a thinning of the internal elastic lamina exposed to chronic arterial hypertension or as a result of degeneration and atherosclerosis of the arterial wall with age. When treatment is indicated, several techniques to relieve compression have been proposed, but they are usually challenging and nonstandardized. ⋯ The patient gave written consent for participating in the procedure, surgical video, and publication of her images. Unfortunately, we did not take the picture of patient positioning for this specific case. For this reason, in order to better illustrate this surgical phase, we used the picture of another patient, who expressed her consent for publication and was operated on for a microvascular decompression with the same position as the one used for the patient described in this paper.
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Trigeminal neuralgia (TN) is a common pain syndrome of the nervous system,. Although about 90% patients who were refractory to medications could be free from pain after microvascular decompression (MVD), some patients did experience recurrence. The study aimed to analyze clinical characteristics of patients with recurrent TN, recurrence factors of TN, and prognosis after re-do MVD. ⋯ Teflon granuloma was the most common cause of TN recurrence in current study, new NVC was also saw in some patients. Patients with recurrent TN could get satisfactory results from re-do MVD.
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When conservative therapy fails, microvascular decompression (MVD) has been the preferred treatment of primary trigeminal neuralgia (TN). However, the management of recurrent or persistent TN after MVD can often be difficult. The purpose of the present systematic review was to objectively analyze and summarize the reported literature regarding the feasibility of repeat MVD. ⋯ For patients with recurrent or persistent pain after MVD, the findings from our systematic review support that repeat MVD remains a feasible treatment for recurrent or persistent TN.
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Trigeminal neuralgia (TN) is a disease characterized by recurring, short-lived, electric shock-like pain experienced on one side of the face. Microvascular decompression (MVD) is one of the most effective surgical interventions for resolving TN caused by neurovascular compression. This study aimed to determine the predictive and prognostic factors of surgical outcomes. ⋯ In our study, atypical TN and severe venous compression were associated with poor outcomes. Regrouping atypical TN into precise diagnosis represents an immediate priority according to our result. The preoperative BNI score could be used as an effective predictive tool for the outcome of MVD surgery.