title: Clinical analysis and surgical treatment of trigeminal neuralgia caused by vertebrobasilar dolichoectasia: A retrospective study.
abstract: BACKGROUND
  Trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia (VBD) is rare and needs further exploration. The purpose of this study is to investigate the clinical features and surgical treatment of TN caused by VBD.
  
  
  METHODS
  15 patients with TN caused by VBD were included in our study. The patient data regarding clinical characteristics, neuroimaging presentations, intraoperative findings and treatment outcomes were analyzed retrospectively. Moreover, the previous relevant literature was reviewed simultaneously. Simple MVD was performed in 13 cases and MVD plus trigeminal nerve selective partial posterior rhizotomy (SPPR) was conducted in 2 patients.
  
  
  RESULTS
  Of all patients, 7 cases were female and 8 were male. The average age at operation was 60.8 years old (range, 35yrs-75yrs). 13 patients suffered from hypertension and 7 had a history of stoke. The extended and ectatic vetebrobasilar artery (VBA) was preliminarily identified in preoperative imaging presentations and finally confirmed during surgical procedure. The facial neuralgia disappeared immediately after surgery in all patients. All patients were relieved of pain (BNI score I) with an average of 29.8 months follow-up.
  
  
  CONCLUSIONS
  Our results suggest that simple MVD is effective for TN caused by VBD. MVD plus SPPR can be cautiously performed if patient has advanced age and is susceptible to numbness.
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Shoujia
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Junwen
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Pan
authors.initials: P
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Liwu
authors.initials: L
authors.lastname: Jiao
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China. Electronic address: kshu@tjh.tjmu.edu.cn.
authors.forename: Kai
authors.initials: K
authors.lastname: Shu
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095#, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
authors.forename: Ting
authors.initials: T
authors.lastname: Lei
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000150:complications*
keywords: Microvascular decompression; Trigeminal neuralgia; Vertebrobasilar dolichoectasia