Articles: microvascular-decompression-surgery.
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Comparative Study
Microvascular Decompression Versus Stereotactic Radiosurgery for Trigeminal Neuralgia: A single institution experience.
Microvascular decompression (MVD) is the standard surgical procedure for patients with medically refractory trigeminal neuralgia (TN). Stereotactic radiosurgery (SRS) has gained increasing popularity as a less invasive technique. We report our institution's outcome in the surgical treatment of TN (MVD vs. SRS), taking patient's age and gender into consideration. ⋯ Factoring in patients' age and gender, both MVD and SRS can achieve a favorable outcome for medically refractory TN, although BNI scores of IV and V were more common with SRS.
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Short-lasting unilateral neuralgiform headache attacks (SUNHA), within the group of trigeminal autonomic cephalalgias, are characterized by repetitive, brief and severe attacks. The SUNHA includes short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). SUNCT is diagnosed if both conjunctival injection and tearing occur ipsilateral to the pain, whereas SUNA is diagnosed if only one, or neither, of conjunctival injection and tearing occurs. ⋯ There is considerable clinical, therapeutic and radiological overlap between SUNCT, SUNA, and trigeminal neuralgia. Despite being considered distinct conditions, the emerging evidence suggests a broader nosological concept of SUNCT, SUNA, and trigeminal neuralgia; these conditions may constitute a continuum of the same disorder, rather than separate clinical entities. This article discusses the clinical aspects of the syndrome, including pathophysiology, differential diagnosis, radiological imaging and treatment. (Received May 26, 2020; Accepted June 16, 2020; Published November 1, 2020).
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The aim of this study was to predict early delirium after microvascular decompression using machine learning. ⋯ Machine learning algorithms predict the occurrence of delirium after microvascular decompression with an accuracy rate of 96.7%. And the major risk factors for the development of post-cardiac delirium are carbamazepine, hgb, and BUN.
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Acta neurochirurgica · Nov 2020
Historical ArticleThe historical evolution of microvascular decompression for trigeminal neuralgia: from Dandy's discovery to Jannetta's legacy.
Although the symptoms of trigeminal neuralgia (TN) have been well described throughout the history of medicine, its etiology was initially not well understood by most surgeons. The standard procedure used to treat TN today, microvascular decompression (MVD), evolved due to the efforts of numerous neurosurgeons throughout the twentieth century. Walter Dandy was the first to utilize the cerebellar (suboccipital) approach to expose the trigeminal nerve for partial sectioning. ⋯ James Gardner was demonstrating that the removal of offending lesion(s) or decompression of nearby vasculature alleviated pressure on the trigeminal nerve and the pain associated with TN. By the 1990s, Peter Jannetta proved Dandy's original hypothesis; he visualized the compression of the trigeminal nerve at the root entry zone in TN patients using an intraoperative microscope. In this paper, we recount the historical evolution of MVD for the treatment of TN.