title: Preoperative evaluation of the neurovascular compression using magnetic resonance tomographic angiography: our radiologic indications for microvascular decompression to treat trigeminal neuralgia.
abstract: OBJECTIVE
  The aim of this study was to introduce our classification of the neurovascular compression (NVC) in trigeminal neuralgia and the radiologic indications for microvascular decompression (MVD) based on magnetic resonance tomographic angiography.
  
  
  METHODS
  From 2003 to 2011, 322 patients with primary trigeminal neuralgia were treated with MVD. The score of NVC was from 0 to 3. Three scores, separately from axial, oblique sagittal, and coronal images, were added together. The degree of NVC was classified as follows: grade 0 (0-1), grade 1 (2-3), grade 2 (4-6), and grade 3 (7-9).
  
  
  RESULTS
  In summary, 88.3% (182/206) patients with absolute indication, 78.3% (65/83) patients with relative indication, and 90.9% (30/33) without indication showed excellent results. Among the 27 patients with good result, 13 patients (48.1%) were in grade 1, and 3 (11.1%) were in grade 0. Among the 18 patients with poor result, 5 patients (27.8%) were in grade 1 preoperatively. Five patients with severe complications were all in grade 0 with vague NVC.
  
  
  CONCLUSIONS
  The patients with grades 2 and 3 (absolute indications) NVC were recommended with MVD.
authors.affiliation: From the Departments of *Oral and Maxillofacial Surgery, †Neurosurgery, and ‡Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
authors.forename: Min-Jie
authors.initials: MJ
authors.lastname: Chen
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Zhang
authors.forename: Zhi-Lin
authors.initials: ZL
authors.lastname: Guo
authors.forename: Chi
authors.initials: C
authors.lastname: Yang
authors.forename: Wen-Hao
authors.initials: WH
authors.lastname: Zhang
authors.forename: Min-Jun
authors.initials: MJ
authors.lastname: Dong
authors.forename: Ying
authors.initials: Y
authors.lastname: Chai
authors.forename: Zhi-yuan
authors.initials: ZY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000145:classification / Q000601:surgery; D044583:Neuroendoscopy / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology; D011300:Preoperative Care; D012008:Recurrence; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000473:pathology / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000145:classification* / Q000601:surgery; D055815:Young Adult