title: Management of intraneural vessels during microvascular decompression surgery for trigeminal neuralgia.
abstract: OBJECTIVE
  To present the authors' experience in surgical treatment of patients with trigeminal neuralgia (TN) with intraneural vessels.
  
  
  METHODS
  The study included three patients with TN and an intraneural artery (superior cerebellar artery) and eight patients with TN and an intraneural vein. The patients underwent microvascular decompression (MVD) procedures. The intraneural arteries were wrapped by a thin piece of Teflon sponge. The intraneural veins all were coagulated and divided. Clinical outcomes and postoperative complications were analyzed.
  
  
  RESULTS
  Eight patients were free of facial pain soon after surgery, achieving excellent outcomes; two patients had good outcomes; and one patient had a failed first operation but experienced pain relief after reoperation, achieving an excellent outcome. Three patients had postoperative facial numbness because the trigeminal nerves were impaired owing to coagulation or mechanical injury. However, no dense corneal numbness or loss of corneal reflex occurred.
  
  
  CONCLUSIONS
  If the intraneural vessel is an artery, it can be decompressed by wrapping techniques. Otherwise, intraneural veins should be coagulated and divided. Most patients can achieve excellent or good pain relief with this approach; facial numbness is uncommon.
authors: Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China.
authors: Xuesheng
authors: X
authors: Zheng
authors: Baohui
authors: B
authors: Feng
authors: Wenyao
authors: W
authors: Hong
authors: Wenchuan
authors: W
authors: Zhang
authors: Min
authors: M
authors: Yang
authors: Yinda
authors: Y
authors: Tang
authors: Jun
authors: J
authors: Zhong
authors: Xuming
authors: X
authors: Hua
authors: Shiting
authors: S
authors: Li
mesh_terms: D000368:Aged; D002536:Cerebral Arteries / Q000033:anatomy & histology* / Q000601:surgery*; D002550:Cerebral Veins / Q000033:anatomy & histology* / Q000601:surgery*; D005157:Facial Pain / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000473:pathology; D012008:Recurrence; D012086:Reoperation; D017211:Treatment Failure; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene