Neurovascular compression anatomy and pain outcome in patients with classic trigeminal neuralgia treated by radiosurgery

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dc.contributor.authorLorenzoni, Jose G.
dc.contributor.authorMassager, Nicolas
dc.contributor.authorDavid, Philippe
dc.contributor.authorDevriendt, Daniel
dc.contributor.authorDesmedt, Francoise
dc.contributor.authorBrotchi, Jacques
dc.contributor.authorLevivier, Marc
dc.date.accessioned2024-01-10T13:51:04Z
dc.date.available2024-01-10T13:51:04Z
dc.date.issued2008
dc.description.abstractOBJECTIVE: To study the influence of the anatomy of neurovascular compression (NVC) on pain outcome in patients with classic trigeminal neuralgia treated by radiosurgery.
dc.description.abstractMETHODS: Analysis of the anatomy of the trigeminal nerve, brainstem, and vessels was performed in 89 consecutive patients treated by Leksell gamma knife (Elekta Instruments Stockholm, Sweden) for classic trigeminal neuralgia. One-millimeter axial magnetic resonance imaging slices (T1 -weighted, T1 -weighted enhanced, and T2-weighted selected partial inversion recovery) with coronal, sagittal, and three-dimensional reconstructions were viewed. The end point for outcome was total pain remission and no medication. The follow-up period ranged between 6 and 42 months.
dc.description.abstractRESULTS: In 82 patients (92%), a vascular structure in contact with the nerve was observed. In four patients, the NVC was produced by a large vessel (basilar or vertebral artery) and in 78 by a smaller vessel. The superior cerebellar artery was the cause of the NVC in 64 patients (78%). The NVC was proximal (<3 mm to the brainstem) in 34 patients (41%) and distal in 43 patients (52%). Nerve dislocation was present in 29 patients (33%), and nerve atrophy was present in 21 (24%) patients. Visualization of NVC on magnetic resonance imaging scans was not associated with outcome. The two variables associated with poor outcome were a large vessel contacting the nerve with brainstem deformation and proximal NVC. Nerve atrophy and nerve dislocation were not associated with outcome.
dc.description.abstractCONCLUSION: The visualization of NVC, nerve atrophy, and nerve dislocation on magnetic resonance imaging scans was not associated with pain outcome. A large vessel compressing the nerve and deforming the brainstem and proximal NVC were associated with a lesser pain control.
dc.fechaingreso.objetodigital2024-05-16
dc.format.extent8 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1227/01.neu.0000316003.80893.81
dc.identifier.eissn1524-4040
dc.identifier.issn0148-396X
dc.identifier.pubmedidMEDLINE:18382314
dc.identifier.urihttps://doi.org/10.1227/01.neu.0000316003.80893.81
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79575
dc.identifier.wosidWOS:000254500500025
dc.information.autorucMedicina;Lorenzoni J;S/I;80739
dc.issue.numero2
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final375
dc.pagina.inicio368
dc.publisherOXFORD UNIV PRESS INC
dc.revistaNEUROSURGERY
dc.rightsacceso restringido
dc.subjectneurovascular compression
dc.subjectneurovascular conflict
dc.subjectradiosurgery
dc.subjecttrigeminal neuralgia
dc.subjectLINEAR-ACCELERATOR RADIOSURGERY
dc.subjectGAMMA-KNIFE RADIOSURGERY
dc.subjectMICROVASCULAR DECOMPRESSION
dc.subjectSTEREOTACTIC RADIOSURGERY
dc.subjectSURGERY
dc.subjectNERVE
dc.titleNeurovascular compression anatomy and pain outcome in patients with classic trigeminal neuralgia treated by radiosurgery
dc.typeartículo
dc.volumen62
sipa.codpersvinculados80739
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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