Abstract:
OBJECTIVE:To retrospectively assess the surgical outcomes and complication rates following microvascular decompression (MVD) for trigeminal neuralgia, using a targeted, restricted retrosigmoid approach. METHODS:During the period 1994-2009, a total of 119 patients underwent MVD for trigeminal neuralgia. A retrospective review was conducted in order to assess pain outcomes following surgery and at most recent follow-up. The intraoperative findings, Barrow Neurologic Institute (BNI) pain scores, medication usage, brainstem auditory evoked potential records, and complication rates (including postoperative hearing status) were reviewed and subsequently analyzed. RESULTS:Of the 119 patients who underwent MVD, 61 (51%) were male and 58 (49%) were female. The mean age was 60 years (range 22-86 years). Operative findings included 94 patients (79%) with arterial compression, 16 patients (13%) with isolated venous compression, 1 patient (1%) with a small arteriovenous malformation, and 8 patients (7%) with no obvious source of compression. No perioperative deaths or major complications, including hearing loss, occurred in any patients. Minor complications occurred in 9 patients (8%), including a transient trochlear nerve palsy in 1 patient, transient nystagmus in 1 patient, cerebrospinal fluid leak requiring revision in 1 patient, wound infections requiring revision in 3 patients, and wound infections requiring antibiotics alone in 3 patients. Follow-up data were available for 109 patients, of whom 88 (81%) had excellent outcomes (BNI Score I-II). Ninety-eight patients (90%) had good outcomes (BNI scores I-IIIb), 7 patients (6%) had persistent pain that was not controlled with medications (BNI Score IV), and 4 patients (4%) experienced no relief following surgery (BNI Score V). CONCLUSION:The use of a small craniectomy (<20 mm) in conjunction with a restricted retrosigmoid approach, inferolateral cerebellar retraction, and maintenance of the vestibular nerve arachnoid may minimize complications and optimize surgical outcomes associated with microvascular decompression for trigeminal neuralgia.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Bond AE,Zada G,Gonzalez AA,Hansen C,Giannotta SLdoi
10.1016/j.wneu.2010.05.001subject
Has Abstractpub_date
2010-07-01 00:00:00pages
172-7issue
1eissn
1878-8750issn
1878-8769pii
S1878-8750(10)00196-8journal_volume
74pub_type
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journal_title:World neurosurgery
pub_type: 杂志文章
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abstract:BACKGROUND:Preservation of neurologic function is mandatory when offering a surgical intervention to patients with low-grade gliomas (LGGs), given that the goal of any treatment is the patient's return to their normal everyday life. OBJECTIVE:To determine whether a structured evaluation by an occupational therapist ca...
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.08.002
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abstract:BACKGROUND:Carotid free-floating thrombus (CFFT) is defined as a blood clot attached to the arterial wall with surrounding blood flow at its distal component. Although rare, it is a clinically significant cause of embolic stroke. CFFT within a stent has not been previously reported. CASE DESCRIPTION:We report a 64-yea...
journal_title:World neurosurgery
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doi:10.1016/j.wneu.2020.06.100
更新日期:2020-09-01 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:2015-12-01 00:00:00
abstract:BACKGROUND:To examine the strength and tolerance of the fibrin glue sealant in a situation of extended transsphenoidal surgery. The withstand pressure of fibrin glue sealant was measured using a simple sellar reconstruction model. METHODS:A 15-mm diameter hole at the bottom of a 51-cm high cylinder was covered with a ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.04.001
更新日期:2010-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.080
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Lumbar arthrodesis is a surgical option for treatment of lumbar pathologies. Stability of the spinal construct partly depends on load-bearing support from back muscles. Despite the role of the psoas muscle in upright spinal stabilization, data describing its clinical significance are scarce. We evaluated the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.11.022
更新日期:2016-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.024
更新日期:2020-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
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更新日期:2018-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2016-03-01 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:2018-08-01 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:2019-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.077
更新日期:2017-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.175
更新日期:2018-04-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.187
更新日期:2019-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.04.153
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Development of a delayed acute epidural hematoma (DEDH) represents a rare event, characterized by a high mortality rate. It is defined as an extradural bleeding not evident at the first brain computed tomography (CT) scan performed after traumatic brain injury but evidenced by further radiologic evaluations....
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.009
更新日期:2020-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.064
更新日期:2018-12-26 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:2016-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.065
更新日期:2017-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2017.01.080
更新日期:2017-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.02.002
更新日期:2013-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.037
更新日期:2019-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.09.029
更新日期:2011-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.186
更新日期:2018-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.131
更新日期:2018-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.159
更新日期:2019-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.01.011
更新日期:2015-04-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.11.046
更新日期:2020-02-01 00:00:00