Anatomical findings in microsurgical vascular decompression for trigeminal neuralgia. Correlations between topography of pain and site of the neuro-vascular conflict.
We here report on the anatomical findings in a series of 350 patients with trigeminal neuralgia (TN) and operated on using a microsurgical key-hole approach to the CPA. In 5.7% there was a tumour or a vascular malformation, in 2.3% a mega-vertebro-basilar-artery. Among the remaining 322 (= real idiopathic TN), only 3.1% had no visible compressive factor, whilst 96.9% had one (or several) conflicting vessel(s): SCA in 90%, AICA in 23.6%, a vein in 24.7%. In 35.7% of the patients, several neurovascular conflicts (NVC) were found. Beside the NVC(s), a global atrophy of the entire root was seen in 67% of the cases. Degree of severity of the NVC and its site along the root were studied. The site of the conflict was: anteriorly to the root when pain was in V1, anteriorly and superiorly when in V2, superiorly and posteriorly when in V3.
Sindou
M
M
Department of Neurosurgery, Neurological Hospital P. Wertheimer, University of Lyon, France.
Chiha
M
M
Mertens
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000473:pathology / Q000601:surgery; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000473:pathology / Q000601:surgery*; D009460:Neurologic Examination; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000473:pathology / Q000601:surgery*