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Trigeminal neuralgia caused by a fibrous ring around the nerve

Case report

Toshikazu Kimura, Tetsuro Sameshima, and Akio Morita

T rigeminal neuralgia is caused by compression of the trigeminal nerve, typically by arteries, and sometimes veins 2 , 6 , 7 or tumors. 1 , 4 Cases of trigeminal neuralgia in the absence of compression have been reported, indicating that the arachnoid membrane around the nerve causes distortion of the trigeminal nerve and pain. 3 Here, we report a case of trigeminal neuralgia caused by a fibrous band around the nerve, which was treated successfully by dissection of the band. Case Report This 26-year-old man had right trigeminal neuralgia. He first

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Gamma knife radiosurgery for primary management for trigeminal neuralgia

Ronald Brisman

G amma knife radiosurgery relieves the pain of trigeminal neuralgia in many patients. 3, 4, 6–9 The present study compares the results of GKS in two groups of patients with trigeminal neuralgia. Patients in Group A underwent GKS as their first neurosurgical intervention. Group B patients underwent GKS after at least one previous neurosurgical procedure. The effects of GKS on trigeminal neuralgia in patients with and without MS are also compared. Clinical Material and Methods One hundred seventy-two patients with trigeminal neuralgia that was not

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Percutaneous retrogasserian glycerol rhizotomy for treatment of trigeminal neuralgia

David W. Beck, Jeffrey J. Olson, and Edward J. Urig

P ercutaneous retrogasserian glycerol rhizotomy (PRGR) for treatment of trigeminal neuralgia is a relatively new procedure that has yielded very promising results. Håkanson 4 reported pain relief in 86% of his 75 patients in the first description of this technique. Since then, Sweet, et al. , 11 reported similar success in 27 patients, as did Lunsford and Bennett 5 in their series of 112 patients. We report our experience with PRGR for the treatment of trigeminal neuralgia in 58 patients treated at University of Iowa Hospitals from January, 1982, through

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A 10-year experience in the treatment of trigeminal neuralgia

Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration

Harry van Loveren, John M. Tew Jr., Jeffrey T. Keller, and Mary A. Nurre

T he treatment of trigeminal neuralgia has been as diverse as explanations of its pathophysiology. The two most widely accepted procedures are percutaneous stereotaxic rhizotomy (PSR) and microvascular decompression (MVD). Injection of chemical substances into the trigeminal nerve and Gasserian ganglion was a common practice during the 19th century. 11, 48 The list of injected substances continued to increase, and by the early 20th century included alcohol, 26, 44 phenol, 48 and boiling water. 28 A certain degree of success was achieved following the

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Arterial cross compression of the trigeminal nerve at the pons in trigeminal neuralgia

Case report with autopsy findings

Stephen J. Haines, A. Julio Martinez, and Peter J. Jannetta

D andy 2 and Jannetta 5 have proposed that trigeminal neuralgia is associated with compression of the trigeminal nerve by branches of the superior cerebellar artery at the root entry zone near the pons. Their observations in large series of patients operated on for trigeminal neuralgia via the posterior fossa seem to support this proposal. 2, 6 Independent confirmation has been reported by Apfelbaum 1 and Petty and Southby, 8 again in operated patients. Another potential source of information for assessing this hypothesis would be postmortem examination of

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Sensory effects of microvascular decompression in trigeminal neuralgia

John B. Miles, Paul R. Eldridge, Carol E. Haggett, and David Bowsher

T rigeminal neuralgia is a condition for which many causes have been sought and many forms of treatment undertaken, with greater or lesser degrees of success. In the preceding article, 5 we discussed the pathophysiology of “idiopathic” trigeminal neuralgia; here we propose to present evidence derived from the effects of one particular form of surgical treatment, that is, microvascular decompression (MVD). Successful medical treatment of trigeminal neuralgia has been possible with administration of anticonvulsant medications, especially carbamazepine. The

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Gamma Knife stereotactic radiosurgery for idiopathic trigeminal neuralgia

Clinical article

Douglas Kondziolka, Oscar Zorro, Javier Lobato-Polo, Hideyuki Kano, Thomas J. Flannery, John C. Flickinger, and L. Dade Lunsford

W hen medical management fails to control the pain of trigeminal neuralgia, patients require surgical intervention. Effective surgical procedures include craniotomy and microvascular decompression or percutaneous ablative procedures. 19 All surgical procedures have variable but definite rates of risk and pain recurrence. Gamma Knife surgery is a minimally invasive surgical approach for managing trigeminal neuralgia. In 1951, Lars Leksell advocated radiosurgery using a prototype guiding device linked to a dental x-ray machine. 14 , 15 During the next 50

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Long-term efficacy of microvascular decompression in trigeminal neuralgia

Kim J. Burchiel, Hadley Clarke, Michael Haglund, and John D. Loeser

A large number of surgical options are available for the management of medically intractable trigeminal neuralgia. One of the most important procedures is microvascular decompression (MVD) of the trigeminal nerve at its root entry zone. This operation, based on the original observations of Dandy, 5 was initially developed by Gardner and Miklos, 8 and was later perfected and popularized by Jannetta. 9 Long-term follow-up data on the efficacy of this procedure in controlling neuralgia is incomplete. Reasonable arguments have been made both for 10, 11 and

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Gamma Knife radiosurgery for bilateral trigeminal neuralgia

Corbin A. Helis, Emory McTyre, Michael T. Munley, J. Daniel Bourland, John T. Lucas Jr., Christina K. Cramer, Stephen B. Tatter, Adrian W. Laxton, and Michael D. Chan

for the treatment of trigeminal neuralgia in multiple sclerosis . World Neurosurg 97 : 590 – 594 , 2017 10.1016/j.wneu.2016.10.028 27756676 2 Attia A , Tatter SB , Weller M , Marshall K , Lovato JF , Bourland JD , : CT-only planning for Gamma Knife radiosurgery in the treatment of trigeminal neuralgia: methodology and outcomes from a single institution . J Med Imaging Radiat Oncol 56 : 490 – 494 , 2012 22883661 10.1111/j.1754-9485.2012.02403.x 3 Barker FG II , Jannetta PJ , Bissonette DJ , Larkins MV , Jho HD : The long

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Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia

Satoshi Maesawa, Camille Salame, John C. Flickinger, Stephen Pirris, Douglas Kondziolka, and L. Dade Lunsford

O nce the diagnosis of trigeminal neuralgia is made, medical therapy becomes the initial approach for most patients. However, medical therapy in many patients fails or they cannot tolerate it, and eventually they require surgical intervention. In the past, surgery typically involved either MVD or one of several percutaneous ablative procedures. 21 Although often associated with initial pain relief, all surgical procedures have variable but definite rates of recurrence and morbidity. The use of GKS has been advocated as a minimally invasive alternative