Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar compression

Mark E. Linskey Department of Neurological Surgery, University of Pittsburgh School of Medicine and Presbyterian University Hospital, Pittsburgh, Pennsylvania

Search for other papers by Mark E. Linskey in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Hae Dong Jho Department of Neurological Surgery, University of Pittsburgh School of Medicine and Presbyterian University Hospital, Pittsburgh, Pennsylvania

Search for other papers by Hae Dong Jho in
Current site
Google Scholar
PubMed
Close
 M.D.
, and
Peter J. Jannetta Department of Neurological Surgery, University of Pittsburgh School of Medicine and Presbyterian University Hospital, Pittsburgh, Pennsylvania

Search for other papers by Peter J. Jannetta in
Current site
Google Scholar
PubMed
Close
 M.D.
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $536.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $636.00
USD  $45.00
USD  $536.00
USD  $636.00
Print or Print + Online Sign in

✓ Thirty-one (2%) of 1404 consecutive patients with typical trigeminal neuralgia who underwent microvascular decompression between 1972 and 1993 were found to have vascular compression by the vertebral artery (VA) or the basilar artery (BA). Compared to the remaining 1373 patients, this subgroup was older (mean age 62 vs. 55 years, p < 0.001), was predominantly male (68% vs. 39%, p < 0.002), demonstrated left-sided predominance (65% vs. 39%, p < 0.002), was more likely to be hypertensive (65% vs. 18%, p < 0.001), and was more likely to have ipsilateral hemifacial spasm (16% vs. 0.6%, p < 0.001). The trigeminal nerve was compressed by the VA in 18 cases (the VA alone in three and the VA plus other vessels in 15), the BA in 12 cases (the BA alone in four and the BA plus other vessels in eight), and the vertebrobasilar junction in one case. Twenty-nine of the 31 patients underwent vascular decompression of the trigeminal nerve, one had a complete trigeminal root section, and one underwent partial root section with vascular decompression of the remaining nerve.

All 31 patients were pain-free, off medication immediately after surgery, and this pain-free, medication-free status was maintained at 1 year after surgery in 96% of cases, at 3 years in 92%, and at 10 years in 86%, based on life-table analysis. Minor trigeminal hypesthesia/hypalgesia was present preoperatively in 52%. New or worsened minor hypesthesia/hypalgesia developed in 41% of patients, while transient diplopia as well as hearing loss developed in 23% and 13% in the overall series, respectively. No patient developed major trigeminal sensory loss or masseter weakness after vascular decompression alone. There was no operative mortality. Vascular decompression is an effective treatment for patients with trigeminal neuralgia who have vertebrobasilar compression of the trigeminal nerve. Patients should be warned that decompression of a tortuous vertebrobasilar system carries a higher risk of mild trigeminal dysfunction, diplopia, and hearing loss than standard microvascular decompression.

  • Collapse
  • Expand
  • 1.

    Al-Mefty O: Petrosal approach for petroclival meningiomas. Neurosurgery 22:510517, 1988 Al-Mefty O: Petrosal approach for petroclival meningiomas. Neurosurgery 22:510–517, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Apfelbaum RI: Surgery for tic douloureux. Clin Neurosurg 31:351368, 1984 Apfelbaum RI: Surgery for tic douloureux. Clin Neurosurg 31:351–368, 1984

  • 3.

    Apfelbaum RI: \Surgical management of disorders of the lower cranial nerves, in Schmidek HH, & Sweet WH (eds): Operative Neurosurgical Techniques. Indications, Methods and Results, ed 2. Orlando: Grune & Stratton, 1988, pp 10971109 Apfelbaum RI: Surgical management of disorders of the lower cranial nerves, in Schmidek HH, Sweet WH (eds): Operative Neurosurgical Techniques. Indications, Methods and Results, ed 2. Orlando: Grune & Stratton, 1988, pp 1097–1109

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Bederson JB, & Wilson CB: Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 71:359367, 1989 Bederson JB, Wilson CB: Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 71:359–367, 1989

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Boeri R, & Passerini A: The megadolichobasilar anomaly. J Neurol Sci 1:475484, 1964 Boeri R, Passerini A: The megadolichobasilar anomaly. J Neurol Sci 1:475–484, 1964

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Burchiel KJ, , Steege TD, & Howe JF, et al: Comparison of percutaneous radiofrequency gangliolysis and microvascular decompression for the surgical management of tic douloureux. Neurosurgery 9:111119, 1981 Burchiel KJ, Steege TD, Howe JF, et al: Comparison of percutaneous radiofrequency gangliolysis and microvascular decompression for the surgical management of tic douloureux. Neurosurgery 9:111–119, 1981

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Campbell E, & Keedy C: Hemifacial spasm: a note on the etiology in two cases. J Neurosurg 4:342347, 1947 Campbell E, Keedy C: Hemifacial spasm: a note on the etiology in two cases. J Neurosurg 4:342–347, 1947

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Corkill G, , Sarwar M, & Virapongse C: Evolution of dolichoectasia of the vertebrobasilar system as evidenced by serial computed tomography. Surg Neurol 18:262266, 1982 Corkill G, Sarwar M, Virapongse C: Evolution of dolichoectasia of the vertebrobasilar system as evidenced by serial computed tomography. Surg Neurol 18:262–266, 1982

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Dandy WE: Concerning the cause of trigeminal neuralgia. Am J Surg 24:447455, 1934 Dandy WE: Concerning the cause of trigeminal neuralgia. Am J Surg 24:447–455, 1934

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Dandy WE: Intracranial Arterial Aneurysms. Ithaca, NY: Comstock, 1944 Dandy WE: Intracranial Arterial Aneurysms. Ithaca, NY: Comstock, 1944

  • 11.

    Frasson F, , Ferrari G, & Fugazzola C, et al: Megadolichobasilar anomaly causing brainstem syndrome. A case report. Neuroradiology 13:279281, 1977 Frasson F, Ferrari G, Fugazzola C, et al: Megadolichobasilar anomaly causing brainstem syndrome. A case report. Neuroradiology 13:279–281, 1977

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Gardner WJ: Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19:947958, 1962 Gardner WJ: Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19:947–958, 1962

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Gardner WJ: Trigeminal neuralgia. Clin Neurosurg 15:156, 1968 Gardner WJ: Trigeminal neuralgia. Clin Neurosurg 15:1–56, 1968

  • 14.

    Gori F, , Del Sindaco F, & Pasqualucci A: Termorizotomia retrogasseriana percutanae a radiofrequenza in un caso di nevralgia del trigemino da ectasia dell'arteria basilare. Minerva Anestesiol 54:531534, 1988 Gori F, Del Sindaco F, Pasqualucci A: Termorizotomia retrogasseriana percutanae a radiofrequenza in un caso di nevralgia del trigemino da ectasia dell'arteria basilare. Minerva Anestesiol 54:531–534, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Goya T, , Wakisaka S, & Kinoshita K: [Microvascular decompression for trigeminal neuralgia with special reference to delayed recurrence.] Neurol Med Chir 30:462467, 1990 (Jpn) Goya T, Wakisaka S, Kinoshita K: [Microvascular decompression for trigeminal neuralgia with special reference to delayed recurrence.] Neurol Med Chir 30:462–467, 1990 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Grigoryan YA, , Dreval ON, & Michailoya SI: Painful tic convulsif caused by a contralateral vertebral artery. Surg Neurol 35:471474, 1991 Grigoryan YA, Dreval ON, Michailoya SI: Painful tic convulsif caused by a contralateral vertebral artery. Surg Neurol 35:471–474, 1991

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Hanakita J, & Kondo A: Serious complications of microvascular decompression operations for trigeminal neuralgia and hemifacial spasm. Neurosurgery 22:348352, 1988 Hanakita J, Kondo A: Serious complications of microvascular decompression operations for trigeminal neuralgia and hemifacial spasm. Neurosurgery 22:348–352, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Harsh GR IV, , Wilson CB, & Hieshmia GB, et al: Magnetic resonance imaging of vertebrobasilar ectasia in tic convulsif. Case report. J Neurosurg 74:9991003, 1991 Harsh GR IV, Wilson CB, Hieshmia GB, et al: Magnetic resonance imaging of vertebrobasilar ectasia in tic convulsif. Case report. J Neurosurg 74:999–1003, 1991

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Hashimoto K, , Fujii K, & Honda T, et al: [Trigeminal neuralgia caused by a dolichoectatic vertebrobasilar artery: a case report.] Rinsho Hoshasen 32:331334, 1987 (Jpn) Hashimoto K, Fujii K, Honda T, et al: [Trigeminal neuralgia caused by a dolichoectatic vertebrobasilar artery: a case report.] Rinsho Hoshasen 32:331–334, 1987 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Hutchins LG, , Harnsberger HR, & Jacobs JM, et al: Trigeminal neuralgia (tic douloureux): MR imaging assessment. Radiology 175:837841, 1990 Hutchins LG, Harnsberger HR, Jacobs JM, et al: Trigeminal neuralgia (tic douloureux): MR imaging assessment. Radiology 175:837–841, 1990

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Jannetta PJ: Microsurgical approach to the trigeminal nerve for tic douloureux. Prog Neurol Surg 7:180200, 1976 Jannetta PJ: Microsurgical approach to the trigeminal nerve for tic douloureux. Prog Neurol Surg 7:180–200, 1976

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Jannetta PJ: Microvascular decompression of the trigeminal nerve root entry zone. Theoretical considerations, operative anatomy, surgical technique, and results, in Rovit RL, , Murali R, & Jannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams &Wilkins, 1990, pp 201222 Jannetta PJ: Microvascular decompression of the trigeminal nerve root entry zone. Theoretical considerations, operative anatomy, surgical technique, and results, in Rovit RL, Murali R, Jannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins, 1990, pp 201–222

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Jannetta PJ: Neurovascular compression in cranial nerve and systemic disease. Ann Surg 192:518525, 1980 Jannetta PJ: Neurovascular compression in cranial nerve and systemic disease. Ann Surg 192:518–525, 1980

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Jannetta PJ, , Segal R, & Wolfson SK Jr: Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients. Ann Surg 201:391398, 1985 Jannetta PJ, Segal R, Wolfson SK Jr: Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients. Ann Surg 201:391–398, 1985

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Jannetta PJ, , Segal R, & Wolfson SK Jr, et al: Neurogenic hypertension: etiology and surgical treatment. II. Observations in an experimental nonhuman primate model. Ann Surg 202:253261, 1985 Jannetta PJ, Segal R, Wolfson SK Jr, et al: Neurogenic hypertension: etiology and surgical treatment. II. Observations in an experimental nonhuman primate model. Ann Surg 202:253–261, 1985

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Klun B: Microvascular decompression and partial sensory rhizotomy in the treatment of trigeminal neuralgia: personal experience with 220 patients. Neurosurgery 30:4952, 1992 Klun B: Microvascular decompression and partial sensory rhizotomy in the treatment of trigeminal neuralgia: personal experience with 220 patients. Neurosurgery 30:49–52, 1992

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Kolluri S, & Heros RC: Microvascular decompression for trigeminal neuralgia. A five-year follow-up study. Surg Neurol 22:235240, 1984 Kolluri S, Heros RC: Microvascular decompression for trigeminal neuralgia. A five-year follow-up study. Surg Neurol 22:235–240, 1984

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Koyanagi S, , Shiraishi T, & Ueta K, et al: [Bilateral fenestrations of the vertebrobasilar artery with trigeminal neuralgia: case report.] Neurol Med Chir 31:995998, 1991 (Jpn) Koyanagi S, Shiraishi T, Ueta K, et al: [Bilateral fenestrations of the vertebrobasilar artery with trigeminal neuralgia: case report.] Neurol Med Chir 31:995–998, 1991 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Lewy FH, & Grant FC: Physiopathologic and pathoanatomic aspects of major trigeminal neuralgia. Arch Neurol Psychiatry 40:11261134, 1938 Lewy FH, Grant FC: Physiopathologic and pathoanatomic aspects of major trigeminal neuralgia. Arch Neurol Psychiatry 40:1126–1134, 1938

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Lye RH: Basilar artery ectasia: an unusual cause of trigeminal neuralgia. J Neurol Neurosurg Psychiatry 49:2228, 1986 Lye RH: Basilar artery ectasia: an unusual cause of trigeminal neuralgia. J Neurol Neurosurg Psychiatry 49:22–28, 1986

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Matsumoto S, , Kishikawa T, & Kudo S, et al: [Radiology of trigeminal neuralgia — with special reference to CT findings.] Nippon Igaku Hoshasen Gakkai Zasshi 50:490498, 1990 (Jpn) Matsumoto S, Kishikawa T, Kudo S, et al: [Radiology of trigeminal neuralgia — with special reference to CT findings.] Nippon Igaku Hoshasen Gakkai Zasshi 50:490–498, 1990 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Miner ME, , Rea GL, & Handel S, et al: Trigeminal neuralgia due to dolichoectasia: angiographic and CT findings in a patient with the EEC syndrome. Neuroradiology 20:163166, 1980 Miner ME, Rea GL, Handel S, et al: Trigeminal neuralgia due to dolichoectasia: angiographic and CT findings in a patient with the EEC syndrome. Neuroradiology 20:163–166, 1980

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Miyagi J, , Hanabusa Y, & Kuramoto S, et al: [Neurovascular decompression for trigeminal neuralgia associated with hemifacial spasm. Case report.] Neurol Med Chir 26:900903, 1986 (Jpn) Miyagi J, Hanabusa Y, Kuramoto S, et al: [Neurovascular decompression for trigeminal neuralgia associated with hemifacial spasm. Case report.] Neurol Med Chir 26:900–903, 1986 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Miyazaki S, , Fukushima T, & Tamagawa T, et al: [Trigeminal neuralgia due to compression of the trigeminal root by a basilar artery trunk: report of 45 cases.] Neurol Med Chir 27:742748, 1987 (Jpn) Miyazaki S, Fukushima T, Tamagawa T, et al: [Trigeminal neuralgia due to compression of the trigeminal root by a basilar artery trunk: report of 45 cases.] Neurol Med Chir 27:742–748, 1987 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Møller AR, & Møller MB: Does intraoperative monitoring of auditory evoked potentials reduce incidence of hearing loss as a complication of microvascular decompression of cranial nerve? Neurosurgery 24:257263, 1989 Møller AR, Møller MB: Does intraoperative monitoring of auditory evoked potentials reduce incidence of hearing loss as a complication of microvascular decompression of cranial nerve? Neurosurgery 24:257–263, 1989

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Mori K, , Morimoto M, & Kurisada M, et al: Analysis of microvascular decompression for the treatment of trigeminal neuralgia and hemifacial spasm. Nippon Geka Hokan 55:768776, 1986 Mori K, Morimoto M, Kurisada M, et al: Analysis of microvascular decompression for the treatment of trigeminal neuralgia and hemifacial spasm. Nippon Geka Hokan 55:768–776, 1986

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Nagaseki Y, , Horikoshi T, & Omata T, et al: Oblique sagittal magnetic resonance imaging visualizing vascular compression of the trigeminal or facial nerve. J Neurosurg 77:379386, 1992 Nagaseki Y, Horikoshi T, Omata T, et al: Oblique sagittal magnetic resonance imaging visualizing vascular compression of the trigeminal or facial nerve. J Neurosurg 77:379–386, 1992

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Naraghi R, , Gaab MR, & Walter GF, et al: Arterial hypertension and neurovascular compression at the ventrolateral medulla. A comparative microanatomical and pathological study. J Neurosurg 77:103112, 1992 Naraghi R, Gaab MR, Walter GF, et al: Arterial hypertension and neurovascular compression at the ventrolateral medulla. A comparative microanatomical and pathological study. J Neurosurg 77:103–112, 1992

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Neagoy DR, & Dohn DF: Hemifacial spasm secondary to vascular compression of the facial nerve. Cleve Clin Q 41:205214, 1974 Neagoy DR, Dohn DF: Hemifacial spasm secondary to vascular compression of the facial nerve. Cleve Clin Q 41:205–214, 1974

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Niizuma H, , Ikeda S, & Ohyama H: [Trigeminal neuralgia and hemifacial spasm caused by the compression of tortuous vertebro-basilar system — case report.] No Shinkei Geka 9:11671170, 1981 (Jpn) Niizuma H, Ikeda S, Ohyama H: [Trigeminal neuralgia and hemifacial spasm caused by the compression of tortuous vertebro-basilar system — case report.] No Shinkei Geka 9:1167–1170, 1981 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Niwa J, , Fujishige N, & Nakawaga T, et al: [use of fenestrated aneurysm clip for transposition of the tortuous vertebral artery.] No Shinkei Geka 16:621624, 1988 (Jpn) Niwa J, Fujishige N, Nakawaga T, et al: [use of fenestrated aneurysm clip for transposition of the tortuous vertebral artery.] No Shinkei Geka 16:621–624, 1988 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Owada K, , Suzuki J, & Iwabuchi T: [Megadolichobasilar anomaly.] No Shinkei Geka 2:699704, 1974 (Jpn) Owada K, Suzuki J, Iwabuchi T: [Megadolichobasilar anomaly.] No Shinkei Geka 2:699–704, 1974 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Petty PG, & Southby R: Vascular compression of lower cranial nerves: observations using microsurgery, with particular reference to trigeminal neuralgia. Aust NZ J Surg 47:314320, 1977 Petty PG, Southby R: Vascular compression of lower cranial nerves: observations using microsurgery, with particular reference to trigeminal neuralgia. Aust NZ J Surg 47:314–320, 1977

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Piatt JH Jr, & Wilkins RH: Treatment of tic douloureux and hemifacial spasm by posterior fossa exploration: therapeutic implications of various neurovascular relationships. Neurosurgery 14:462471, 1984 Piatt JH Jr, Wilkins RH: Treatment of tic douloureux and hemifacial spasm by posterior fossa exploration: therapeutic implications of various neurovascular relationships. Neurosurgery 14:462–471, 1984

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Pulsinelli WA, & Rottenberg DA: Painful tic convulsif. J Neurol Neurosurg Psychiatry 40:192195, 1977 Pulsinelli WA, Rottenberg DA: Painful tic convulsif. J Neurol Neurosurg Psychiatry 40:192–195, 1977

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Resta M, , Gentile MA, & Di Cuonzo F, et al: Clinical-angiographic correlations in 132 patients with megadolicho-vertebrobasilar anomaly. Neuroradiology 26:213216, 1984 Resta M, Gentile MA, Di Cuonzo F, et al: Clinical-angiographic correlations in 132 patients with megadolicho-vertebrobasilar anomaly. Neuroradiology 26:213–216, 1984

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Richards P, , Shawdon H, & Illingworth R: Operative findings on microsurgical exploration of the cerebello-pontine angle in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 46:10981101, 1983 Richards P, Shawdon H, Illingworth R: Operative findings on microsurgical exploration of the cerebello-pontine angle in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 46:1098–1101, 1983

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Scott M, & Stauffer HM: A case of aneurysmal malformation of the vertebral and basilar arteries causing cranial nerve involvement. AJR 92:836837, 1984 Scott M, Stauffer HM: A case of aneurysmal malformation of the vertebral and basilar arteries causing cranial nerve involvement. AJR 92:836–837, 1984

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Sindou M, , Amrani F, & Mertens P: Décompression vasculaire microchirurgicale pour névralgie du trijumeau: comparison de deux modalités techniques et déductions physiopathologiques. Étude sur 120 cas. Neurochirurgie 36:1626, 1990 Sindou M, Amrani F, Mertens P: Décompression vasculaire microchirurgicale pour névralgie du trijumeau: comparison de deux modalités techniques et déductions physiopathologiques. Étude sur 120 cas. Neurochirurgie 36:16–26, 1990

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Stopford JSB: The arteries of the pons and medulla oblongata. J Anat Physiol 50:131164, 1916 Stopford JSB: The arteries of the pons and medulla oblongata. J Anat Physiol 50:131–164, 1916

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Suzuki S, , Tsuchita H, & Kurokawa Y, et al: [New methods of MVD using a vascular tape for neurovascular compression involving the vertebrobasilar artery — report of two cases.] Neurol Med Chir 30:10301032, 1990 (Jpn) Suzuki S, Tsuchita H, Kurokawa Y, et al: [New methods of MVD using a vascular tape for neurovascular compression involving the vertebrobasilar artery — report of two cases.] Neurol Med Chir 30:1030–1032, 1990 (Jpn)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Szapiro J Jr, & Sindou M: Traitement microchirurgical de la névralgie du trijumeau. Résultats et facteurs pronostiques de la décompression vasculaire microchirurgicale. Neurochirurgie 32:103121, 1986 Szapiro J Jr, Sindou M: Traitement microchirurgical de la névralgie du trijumeau. Résultats et facteurs pronostiques de la décompression vasculaire microchirurgicale. Neurochirurgie 32:103–121, 1986

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Takamiya Y, , Toya S, & Kawase T, et al: Trigeminal neuralgia and hemifacial spasm caused by a tortuous vertebrobasilar system. Surg Neurol 24:559562, 1985 Takamiya Y, Toya S, Kawase T, et al: Trigeminal neuralgia and hemifacial spasm caused by a tortuous vertebrobasilar system. Surg Neurol 24:559–562, 1985

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Tash RR, , Sze G, & Leslie DR: Trigeminal neuralgia: MR imaging features. Radiology 172:767770, 1989 Tash RR, Sze G, Leslie DR: Trigeminal neuralgia: MR imaging features. Radiology 172:767–770, 1989

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    van Loveren H, , Tew JM Jr, & Keller JT, et al: A 10-year experience in the treatment of trigeminal neuralgia. Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration. J Neurosurg 57:757764, 1982 van Loveren H, Tew JM Jr, Keller JT, et al: A 10-year experience in the treatment of trigeminal neuralgia. Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration. J Neurosurg 57:757–764, 1982

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Waga S, , Morikawa A, & Kojima T: Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg Neurol 11:1316, 1979 Waga S, Morikawa A, Kojima T: Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg Neurol 11:13–16, 1979

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Winkler D, , Nowak G, & Freckmann N: Tic convulsif in Kombination mit Drehschwindelattacken und dessen operative Behandlung durch microvasculäre Decompression. Nervenarzt 58:4748, 1987 Winkler D, Nowak G, Freckmann N: Tic convulsif in Kombination mit Drehschwindelattacken und dessen operative Behandlung durch microvasculäre Decompression. Nervenarzt 58:47–48, 1987

    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1813 310 23
Full Text Views 438 36 7
PDF Downloads 238 48 10
EPUB Downloads 0 0 0