title: Role of trigeminal microvascular decompression in the treatment of SUNCT and SUNA.
abstract: Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are primary headache disorders. Evidence suggests that SUNCT/SUNA have similar pathophysiology to the trigeminal autonomic cephalalgias and involves the trigeminal autonomic reflex. This review provides an overview of microvascular decompression of the trigeminal nerve and other surgical therapeutic options for SUNCT/SUNA. We have undertaken a mini-meta-analysis of available case reports and case series with the aim of providing recommendations for the use of such therapies in SUNCT/SUNA. There is some evidence supporting microvascular decompression of the trigeminal nerve in selected patients who have medically refractory SUNCT/SUNA and a demonstrable ipsilateral aberrant vessel on magnetic resonance imaging (MRI). We also consider what further investigations could be undertaken to assess the role of surgical interventions in the treatment of these often debilitating conditions.
authors.affiliation: Department of Neurology, Gold Coast Hospital, 108 Nerang Street, Southport, QLD, 4215, Australia.
authors.forename: Swapna
authors.initials: S
authors.lastname: Sebastian
authors.forename: Daniel
authors.initials: D
authors.lastname: Schweitzer
authors.forename: Leong
authors.initials: L
authors.lastname: Tan
authors.forename: Simon A
authors.initials: SA
authors.lastname: Broadley
mesh_terms: D000328:Adult; D000368:Aged; D001340:Autonomic Nerve Block / Q000379:methods; D001341:Autonomic Nervous System / Q000503:physiopathology / Q000601:surgery*; D046690:Deep Brain Stimulation / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods; D008875:Middle Aged; D009778:Occipital Lobe / Q000601:surgery; D019051:Rhizotomy / Q000379:methods; D050798:SUNCT Syndrome / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000503:physiopathology / Q000601:surgery*
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