J Korean Neurosurg Soc.  2012 Jul;52(1):42-47. 10.3340/jkns.2012.52.1.42.

Microvascular Decompression for Primary Trigeminal Neuralgia : Short-Term Follow-Up Results and Prognostic Factors

Affiliations
  • 1Department of Neurosurgery, Erciyes University, Medical School, Kayseri, Turkey.
  • 2Neurosurgery Clinic, Ministry of Health, Sevket Yilmaz Research and Training Hospital, Bursa, Turkey. mehmetali.ekici@gmail.com
  • 3Neurosurgery Clinic, Ministry of Health, Soke State Hospital, Aydin, Turkey.
  • 4Department of Neurosurgery, Mustafa Kemal University, Hatay, Turkey.

Abstract


OBJECTIVE
The aim of this prospective study was to demonstrate the influence of some factors on the prognosis of microvascular decompression in 37 patients with trigeminal neuralgia.
METHODS
The results of microvascular decompression (MVD) in 37 patients with trigeminal neuralgia were evaluated at 6 months after surgery and were compared with clinical and operative findings.
RESULTS
The sex of the patient, the patient's age at surgery, the side of the pain, and the duration of symptoms before surgery did not play any significant roles in prognosis. Also, the visual analogue scale (VAS) of the patient, the duration of each pain attack, and the frequency of pain over 24 hours did not play any significant roles in prognosis. In addition, intraoperative detection of the type of conflicting vessel, the degree of severity of conflict, and the location of the conflict around the circumference of the root did not play any roles in prognosis. The only factors affecting the prognosis in MVD surgery were intraoperative detection of the site of the conflict along the root and neuroradiological compression signs on preoperative magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA).
CONCLUSION
These findings demonstrated that if neurovascular compression is seen on preoperative MRI/MRA and/or compression is found intraoperative at the root entry zone, then the patient will most likely benefit from MVD surgery.

Keyword

Cranial nerve vascular compression syndromes; Microvascular decompression; Prognosis; Trigeminal neuralgia

MeSH Terms

Angiography
Follow-Up Studies
Glycosaminoglycans
Humans
Magnetic Resonance Imaging
Microvascular Decompression Surgery
Prognosis
Prospective Studies
Trigeminal Neuralgia
Glycosaminoglycans

Reference

1. Bederson JB, Wilson CB. Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg. 1989; 71:359–367. PMID: 2769387.
Article
2. Burchiel KJ. A new classification for facial pain. Neurosurgery. 2003; 53:1164–1166. discussion 1166-1167. PMID: 14580284.
Article
3. Burchiel KJ, Clarke H, Haglund M, Loeser JD. Long-term efficacy of microvascular decompression in trigeminal neuralgia. J Neurosurg. 1988; 69:35–38. PMID: 2454303.
Article
4. Burchiel KJ, Slavin KV. On the natural history of trigeminal neuralgia. Neurosurgery. 2000; 46:152–154. discussion 154-155. PMID: 10626945.
Article
5. Fraioli B, Esposito V, Guidetti B, Cruccu G, Manfredi M. Treatment of trigeminal neuralgia by thermocoagulation, glycerolization, and percutaneous compression of the gasserian ganglion and/or retrogasserian rootlets : long-term results and therapeutic protocol. Neurosurgery. 1989; 24:239–245. PMID: 2783993.
Article
6. Fujimaki T, Fukushima T, Miyazaki S. Percutaneous retrogasserian glycerol injection in the management of trigeminal neuralgia : long-term follow-up results. J Neurosurg. 1990; 73:212–216. PMID: 2195139.
Article
7. Grantham EG, Segerberg LH. An evaluation of palliative surgical procedures in trigeminal neuralgia. J Neurosurg. 1952; 9:390–394. PMID: 14946579.
Article
8. Guclu B, Sindou M, Meyronet D, Streichenberger N, Simon E, Mertens P. Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharyngeal nerves : comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes. Acta Neurochir (Wien). 2011; 153:2365–2375. PMID: 21947457.
Article
9. Hilton DA, Love S, Gradidge T, Coakham HB. Pathological findings associated with trigeminal neuralgia caused by vascular compression. Neurosurgery. 1994; 35:299–303. discussion 303. PMID: 7969838.
Article
10. Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg. 1967; 26:159–162. PMID: 6018932.
Article
11. Jannetta PJ. Microsurgery of cranial nerve cross-compression. Clin Neurosurg. 1979; 26:607–615. PMID: 232435.
Article
12. Jannetta PJ. Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations. Clin Neurosurg. 1977; 24:538–549. PMID: 583698.
Article
13. Jannetta PJ. Trigeminal neuralgia : Treatment by microvascular decompression. Neurosurgery. 1985; 3:2357–2366.
14. Kanpolat Y, Avman N, Gökalp HZ, Arasil E, Selçuki M, Mertol T. Effectiveness of radiofrequency thermocoagulation in recurrent trigeminal neuralgia after previous retrogasserian rhizotomy. Appl Neurophysiol. 1985; 48:258–261. PMID: 3879792.
Article
15. Kuncz A, Vörös E, Barzó P, Tajti J, Milassin P, Mucsi Z, et al. 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. 2006; 26:266–276. PMID: 16472332.
Article
16. Leal PR, Hermier M, Froment JC, Souza MA, Cristino-Filho G, Sindou M. 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 (Wien). 2010; 152:817–825. PMID: 20108106.
Article
17. Leal PR, Hermier M, Souza MA, Cristino-Filho G, Froment JC, Sindou M. Visualization of vascular compression of the trigeminal nerve with high-resolution 3T MRI : a prospective study comparing preoperative imaging analysis to surgical findings in 40 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Neurosurgery. 2011; 69:15–25. discussion 26. PMID: 21346659.
18. Li ST, Wang X, Pan Q, Hai J, Liu N, Shen F, et al. Studies on the operative outcomes and mechanisms of microvascular decompression in treating typical and atypical trigeminal neuralgia. Clin J Pain. 2005; 21:311–316. PMID: 15951648.
Article
19. Merrison AF, Fuller G. Treatment options for trigeminal neuralgia. BMJ. 2003; 327:1360–1361. PMID: 14670852.
Article
20. Rughani AI, Dumont TM, Lin CT, Tranmer BI, Horgan MA. Safety of microvascular decompression for trigeminal neuralgia in the elderly. Clinical article. J Neurosurg. 2011; 115:202–209. PMID: 21568658.
Article
21. Sindou M, Leston J, Decullier E, Chapuis F. Microvascular decompression for primary trigeminal neuralgia : long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. J Neurosurg. 2007; 107:1144–1153. PMID: 18077952.
Article
22. Sindou M, Leston J, Howeidy T, Decullier E, Chapuis F. Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients. Acta Neurochir (Wien). 2006; 148:1235–1245. discussion 1245. PMID: 16804643.
Article
23. Sindou M, Leston JM, Decullier E, Chapuis F. Microvascular decompression for trigeminal neuralgia : the importance of a noncompressive technique--Kaplan-Meier analysis in a consecutive series of 330 patients. Neurosurgery. 2008; 63:341–350. discussion 350-351. PMID: 18981841.
24. Tatli M, Satici O, Kanpolat Y, Sindou M. Various surgical modalities for trigeminal neuralgia : literature study of respective long-term outcomes. Acta Neurochir (Wien). 2008; 150:243–255. PMID: 18193149.
Article
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