title: Arterial compression of nerve is the primary cause of trigeminal neuralgia.
abstract: Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of trigeminal neuralgia who were treated with microvascular decompression. The study included 99 patients with trigeminal neuralgia (median age, 57 years) and 101 patients with hemifacial spasm (median age, 47 years). There were significant differences between the groups in the relationship of artery to nerve (p < 0.001) and the presence of arachnoid adhesions (p < 0.001) but no significant difference in relationship of vein to nerve. After adjustment for age, gender, and other factors, patients with vein compression of nerve or with artery compression of nerve were more likely to have trigeminal neuralgia (OR = 5.21 and 42.54, p = 0.026 and p < 0.001, respectively). Patients with arachnoid adhesions were less likely to have trigeminal neuralgia (OR = 0.15, p = 0.038). Arterial compression of the trigeminal nerve is the primary cause of trigeminal neuralgia and therefore, decompression of veins need not be a priority when performing microvascular dissection in patients with trigeminal neuralgia.
authors: Department of Neurosurgery, Yuquan Hospital of Tsinghua University, 5 Shijing Shan Road, Shi Jing Shan District, Beijing, 100049, China.
authors: Guo-Qiang
authors: GQ
authors: Chen
authors: Xiao-Song
authors: XS
authors: Wang
authors: Lin
authors: L
authors: Wang
authors: Jia-Ping
authors: JP
authors: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology*; D016022:Case-Control Studies; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000601:surgery
references: Acta Neurochir (Wien). 2011 Dec;153(12):2365-75
references: 21947457
references: Curr Opin Neurol. 2012 Jun;25(3):296-301
references: 22547101
references: J Korean Neurosurg Soc. 2012 Jul;52(1):42-7
references: 22993677
references: Med Hypotheses. 2010 Mar;74(3):505-7
references: 19900765
references: Clin Neurosurg. 1985;32:319-33
references: 3905143
references: J Neurosurg. 2008 Mar;108(3):483-90
references: 18312095
references: Neurosurgery. 2001 Jun;48(6):1261-7; discussion 1267-8
references: 11383728
references: Magn Reson Imaging. 2012 Jun;30(5):666-71
references: 22405984
references: Neurol Sci. 2008 May;29 Suppl 1:S191-5
references: 18545932
references: Pain Physician. 2012 Mar-Apr;15(2):187-96
references: 22430657
references: JAAPA. 2011 Jul;24(7):20-5
references: 21748954
references: Pain. 2011 Oct;152(10):2357-2364
references: 21835547
references: Acta Neurochir (Wien). 2011 May;153(5):1037-42
references: 21298451
references: Br J Anaesth. 2001 Jul;87(1):117-32
references: 11460800
references: J Neurosurg. 2009 Aug;111(2):351-8
references: 19326987
references: World Neurosurg. 2013 May-Jun;79(5-6):756-62
references: 22381868
references: Neurosurg Rev. 2010 Jul;33(3):325-34; discussion 334
references: 20349099
references: Acta Neurochir (Wien). 2010 May;152(5):817-25
references: 20108106
references: J Neurosurg. 2011 Jan;114(1):172-9
references: 20653393
references: Am Fam Physician. 2008 May 1;77(9):1291-6
references: 18540495
references: Brain. 2001 Dec;124(Pt 12):2347-60
references: 11701590
references: Neurol India. 2009 Mar-Apr;57(2):134-8
references: 19439841
references: BMJ. 2007 Jan 27;334(7586):201-5
references: 17255614
references: Skull Base. 2011 Sep;21(5):313-22
references: 22451832