Articles: microvascular-decompression-surgery.
-
Journal of neurosurgery · Jun 2015
Comparative StudySensory abnormalities and masticatory function after microvascular decompression or balloon compression for trigeminal neuralgia compared with carbamazepine and healthy controls.
Idiopathic trigeminal neuralgia (iTN) is a neurological condition treated with pharmacotherapy or neurosurgery. There is a lack of comparative papers regarding the outcomes of neurosurgery in patients with iTN. The objective of this study was to investigate sensory thresholds and masticatory function in 78 patients with iTN who underwent microvascular decompression (MVD) or balloon compression (BC), and compare these treatments with carbamazepine and 30 untreated healthy controls. ⋯ Microvascular decompression and BC resulted in a reduction in myofascial and jaw articular complaints, and the impact on masticatory function according to Helkimo indices was greater after BC than MVD. MVD resulted in more gustative alterations, and both procedures caused impairment in thermal thresholds (warm and cold). However, only BC also affected touch perception. The sensorial and motor deficits after BC need to be included as targets directly associated with the success of the surgery and need to be assessed and relieved as goals in the treatment of iTN.
-
Case Reports
A Successful Treatment of Coexistent Trigeminal Neuralgia and Ipsilateral Superior Cerebellar Artery Aneurysm.
A 71-year-old woman had presented to our clinic with the history of trigeminal neuralgia involving the second and third divisions on the right side. The magnetic resonance tomography angiography examination before operation revealed that the root of the right trigeminal nerve was compressed by the superior cerebellar artery (SCA) artery. ⋯ The symptoms of pain disappeared after the surgery of microvascular decompression and the wrapping of the SCA aneurysm. Trigeminal neuralgia coexisting with the aneurysm of the ipsilateral SCA is extremely rare, and it has not been reported before.
-
Journal of neurosurgery · Jun 2015
Case ReportsSubtemporal transtentorial approach for recurrent trigeminal neuralgia after microvascular decompression via the lateral suboccipital approach: case report.
Microvascular decompression (MVD) via lateral suboccipital craniotomy is the standard surgical intervention for trigeminal neuralgia (TN). For recurrent TN, difficulties are sometimes encountered when performing reoperation via the same approach because of adhesions and prosthetic materials used in the previous surgery. In the present case report the authors describe the efficacy of the subtemporal transtentorial approach for use in recurrent TN after MVD via the lateral suboccipital approach. ⋯ Her TN disappeared after the MVD. The present approach is ideal for visualizing the trigeminal root entry zone, and the neurovascular complex can be easily dissected using a new surgical trajectory. This approach could be another surgical option for reoperation when the previous MVD had been performed via the suboccipital approach.
-
Microvascular decompression (MVD) has been accepted worldwide as a reasonable treatment for hemifacial spasm (HFS); however, resolution of the HFS is often gradual. To conclude the delayed relief rate of the MVD for the treatment of HFS, we conducted a systematic review. Using the keywords delayed relief, hemifacial spasm, or microvascular decompression, articles published in English-language journals and indexed in PubMed between June 1, 1994 and June 1, 2014 on the treatment of HFS with emphasis on delayed relief were considered for this study. ⋯ The mean rate of delayed relief was 25.4% (18.8%-37.1%). Approximately 13.1% (5.9%-19.7%) of the patients with symptom recurrence resorted to repeated MVD during the follow-up period. Accordingly, MVD is the most effective treatment for patients with HFS, but some of the patients may experienced delayed relief, which could be avoided if a thorough decompression of the facial nerve root had been obtained.
-
The objectives of this work are to report the outcomes of our finding during microvascular decompression (MVD) for patients with recurrent trigeminal neuralgia (TN) and to introduce the sling retraction technique. ⋯ Arachnoid adhesion of the Teflon felt and vascular compression to the nerve were main causes of recurrence. The sling retraction technique is still an effective and useful treatment for recurrent TN after MVD.