Abstract：
OBJECTIVE:Classical trigeminal neuralgia (cTN) is rarely caused by ectatic vertebrobasilar artery compression of the trigeminal nerve. These patients present a surgical challenge and often are not considered for microvascular decompression (MVD) due to assumed risk. METHODS:A review of patients who were surgically treated by the senior author between 1997 and 2016 with an admitting diagnosis of cTN was performed. Details of the surgery were documented, including the technique for maintaining vascular decompression, complications, and the length of stay. Clinical follow-up was obtained from patient charts as well as telephone questionnaires. RESULTS:During the 20-year review, 552 patients underwent MVD for cTN, and 13 (2.4%) had dolichoectatic vertebrobasilar compressions (10 male, 3 female). The average hospital length of stay was 2.8 days (range 2-7) with no major complications. At final follow-up (>2 years), 7 had no pain with no medications (78%), 2 had persistent pain (22%)-1 of whom underwent a successful glycerol rhizotomy at 8 months-2 were lost to follow-up, and 2 had surgery within 2 years. CONCLUSIONS:Patients with cTN due to a dolichoectatic vertebrobasilar artery compression present a unique surgical challenge. Mobilizing the vessel can be difficult because it may be firm from atherosclerosis, maintaining its separation from the nerve is similarly difficult, and manipulating the vessel can be dangerous because of its brainstem perforators. Our case series provides some evidence to support the safety and efficacy of MVD for patients with vertebrobasilar ectasia for those that major surgery is not contraindicated.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Honey CM,Kaufmann AMdoi
10.1016/j.wneu.2018.06.145subject
Has Abstractpub_date
2018-10-01 00:00:00pages
e155-e160eissn
1878-8750issn
1878-8769pii
S1878-8750(18)31361-5journal_volume
118pub_type
杂志文章abstract：BACKGROUND:Neurosurgical spine specialists receive considerable amounts of industry support that may impact the cost of care. The aim of this study was to evaluate the association between industry payments received by spine surgeons and the total hospital and operating room (OR) costs of an anterior cervical discectomy...
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2015.05.031
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journal_title：World neurosurgery
pub_type： 传,历史文章,杂志文章
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更新日期：2015-12-01 00:00:00
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pub_type： 历史文章,杂志文章
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pub_type： 杂志文章,随机对照试验
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更新日期：2019-12-01 00:00:00
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pub_type： 杂志文章,评审
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更新日期：2016-04-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2017-08-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2019-06-01 00:00:00
