Trigeminal neuralgia due to neurovascular conflicts from venous origin: an anatomical-surgical study (consecutive series of 124 operated cases)

详细信息    查看全文

• 作者：Chloé Dumot ; Marc Sindou
• 关键词：Trigeminal neuralgia ; Neurovascular conflict ; Neurovascular compression ; Microvascular decompression ; Veins of posterior fossa ; Superior petrosal vein
• 刊名：Acta Neurochirurgica
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：157
• 期：3
• 页码：455-466
• 全文大小：2,440 KB
• 参考文献：1. Barker FG, Jannetta PJ, Bissonette DJ, Jho HD (1997) Trigeminal numbness and tic relief after microvascular decompression for typical trigeminal neuralgia. Neurosurgery 40:39-5
  2. Boecher-Schwarz HG, Bruehl K, Kessel G, Guenthner M, Perneczky A, Stoeter P (1998) Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia. A correlation of MRA and surgical findings. Neuroradiology 40:88-5 CrossRef
  3. Bond AE, Zada G, Gonzalez AA, Hansen C, Giannotta SL (2010) Operative strategies for minimizing hearing loss and other major complications associated with microvascular decompression for trigeminal neuralgia. World Neurosurg 74:172-77 CrossRef
  4. Chen GQ, Wang XS, Wang L, Zheng JP (2014) Arterial compression of nerve is the primary cause of trigeminal neuralgia. Neurol Sci 35:61-6 CrossRef
  5. Ferroli P, Acerbi F, Tomei M, Tringali G, Franzini A, Broggi G (2010) Advanced age as a contraindication to microvascular decompression for drug-resistant trigeminal neuralgia: evidence of prejudice? Neurol Sci 31:23-8 CrossRef
  6. Günther T, Gerganov VM, Stieglitz L, Ludemann W, Samii A, Samii M (2009) Microvascular decompression for trigeminal neuralgia in the elderly: long-term treatment outcome and comparison with younger patients. Neurosurgery 65:477-82, discussion 482 CrossRef
  7. Han-Bing S, Wei-Guo Z, Jun Z, Ning L, Jian-Kang S, Yu C (2010) Predicting the outcome of microvascular decompression for trigeminal neuralgia using magnetic resonance tomographic angiography. J Neuroimaging 20:345-49 CrossRef
  8. Headache Classification Committee of the International Headache Society (IHS) (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629-08 CrossRef
  9. Hong W, Zheng X, Wu Z, Li X, Wang X, Li Y, Zhang W, Zhong J, Hua X, Li S (2011) Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression. Acta Neurochir 153:1037-042 CrossRef
  10. Jo KW, Kong DS, Hong KS, Lee JA, Park K (2013) Long-term prognostic factors for microvascular decompression for trigeminal neuralgia. J Clin Neurosci 20:440-45 CrossRef
  11. Kabatas S, Karasu A, Civelek E, Sabanci AP, Hepgul KT, Teng YD (2009) Microvascular decompression as a surgical management for trigeminal neuralgia: long-term follow-up and review of the literature. Neurosurg Rev 32:87-3, discussion 93-4 CrossRef
  12. Kuncz A, V?r?s E, Barzó P, Tajti J, Milassin P, Mucsi Z, Elek P, Benedek K, Tarjányi J, Bodosi M (2006) Comparison of clinical symptoms and magnetic resonance angiographic (MRA) results in patients with trigeminal neuralgia and persistent idiopathic facial pain. Medium-term outcome after microvascular decompression of cases with positive MRA findings. Cephalalgia 26:266-76 CrossRef
  13. Leal PRL, Hermier M, Froment JC, Souza MA, Cristino-Filho G, Sindou M (2010) Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Acta Neurochir 152:817-25 CrossRef
  14. Li GW, Zhang WC, Yang M, Ma QF, Zhong WX (2014) Clinical characteristics and surgical techniques of trigeminal neuralgia caused simply by venous compression. J Craniofac
• 刊物主题：Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery;
• 出版者：Springer Vienna
• ISSN：0942-0940

文摘

Background Veins as the source of trigeminal neuralgias (TN) lead to controversies. Only a few studies have specifically dealt with venous implication in neurovascular conflicts (NVC). The aim of this study was the anatomical-surgical description of the compressive veins found during micro-vascular decompression (MVD). Methods Patients retained were those in whom a vein was considered compressive, alone, or in association with an artery. The study defined the type of vein involved, its situation along, the location around the root, and management. For this study, denomination of veins in relation with the root was revisited. Results Of the 326 consecutive patients who underwent MVD from 2005 to 2013, 124 (38.0?%) had a venous conflict, alone in 29 (8.9?%), or in association with an artery in 95 (29.1?%). The compressive veins belonged to one of the two venous systems described: the superficial or the deep superior petrosal venous system (sSPVS or dSPVS). A vein from sSPVS was found compressive in 81 cases (59.6?%), for the major part it was the pontine affluent of the superior petrosal vein (48 cases). The conflict was situated at TREZ in 28.4?%, mid-cisternal portion in 50.6?%, and porus in 8.6?%. The dSPVS was found compressive in 55 cases (40.4?%), almost always a transverse vein at porus (51 cases). Decompression was coagulation-division of the conflicting vein in 36.8?% and simple cleavage in the other. Conclusions The study shows the frequent implication of veins in NVC as the source of TN. NVC are not only at TREZ but also at mid-cisternal portion and porus of Meckel cave.