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Trigeminal neuralgia secondary to asymmetry of the petrous bone

Case report

Sixto Obrador, Victor G. Queimadelos, and Manuel Soto

A symmetry of the petrous portion of the temporal bone seems to appear in about 5% of the radiological studies of the skull, but its association with trigeminal neuralgia has not been reported. 4 In certain studies, however, several mechanical factors related to changes and malformations of the base of the skull have been considered in relation to the pathogenesis of the trigeminal neuralgia apparently produced by the stretching of this nerve. 3, 8 Recently we have observed and treated a patient in whom petrous bone asymmetry played an obvious role in the

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Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia

Risheng Xu, Joshua Materi, Divyaansh Raj, Safwan Alomari, Yuanxuan Xia, Sumil K. Nair, Pavan P. Shah, Nivedha Kannapadi, Timothy Kim, Judy Huang, Chetan Bettegowda, and Michael Lim

on behalf of all authors: Lim. Statistical analysis: Materi. Study supervision: Lim. References 1 Yadav YR , Nishtha Y , Sonjjay P , Vijay P , Shailendra R , Yatin K . Trigeminal neuralgia . Asian J Neurosurg . 2017 ; 12 ( 4 ): 585 – 597 . 29114270 10.4103/ajns.AJNS_67_14 2 Cruccu G , Di Stefano G , Truini A . Trigeminal neuralgia . N Engl J Med . 2020 ; 383 ( 8 ): 754 – 762 . 32813951 10.1056/NEJMra1914484 3 Cheshire WP . Trigeminal neuralgia: diagnosis and treatment . Curr Neurol Neurosci Rep . 2005 ; 5 ( 2 ): 79

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Treatment of trigeminal neuralgia with linear accelerator radiosurgery: initial results

Joseph C. T. Chen, Michael Girvigian, Hugh Greathouse, Michael Miller, and Javad Rahimian

T rigeminal neuralgia is the most frequent disorder of the trigeminal nerve with a prevalence in the population of three to five per 100,000 individuals. It is typically characterized by swift lancinating pain confined to the trigeminal nerve distribution. First-line surgical treatment of medically refractory trigeminal neuralgia includes percutaneous rhizolysis as well as MVD. These procedures, while effective, have a significant, albeit low, rate of complications. 3, 5, 12 As a method of destructive lesioning, stereotactic radiosurgery has been of

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Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study

Peter J. Hamlyn and Thomas T. King

I n 1934, Dandy 9 outlined his theory of vascular compression as a cause of trigeminal neuralgia, and pointed to the main problem with that theory; namely, that vascular contact occasionally occurs without the production of pain and may be absent when neuralgia is present. Review of the relevant literature revealed that the percentage of neuralgic patients with significant blood vessels in contact with the trigeminal nerve has varied from as high as 96% 14 to as low as 11%, 3 while the percentage of vascular contacts in normal postmortem controls has ranged

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Trigeminal neuralgia caused by compression from arteries transfixing the nerve

Report of three cases

Haruhiko Tashiro, Akinori Kondo, Ikuhiro Aoyama, Kiyoshi Nin, Katsumi Shimotake, Tatsuya Nishioka, Yoshiaki Ikai, and Jun Takahashi

T rigeminal nerve decompression was first used by Gardner and Sava 4 as a surgical treatment for trigeminal neuralgia and was greatly improved and popularized by Jannetta 5 after the introduction of microsurgical techniques. We have performed trigeminal nerve decompression surgery in 384 patients with trigeminal neuralgia during a 12-year period from 1977 to 1989, with an initial recovery rate of 94.3%. In this series, there were three cases (0.8%) in which the compressing vessel, the superior cerebellar artery (SCA) or the anterior inferior cerebellar

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Microvascular decompression for trigeminal neuralgia in Charcot-Marie-Tooth disease

Report of three cases

Marcus de Matas, Peter Francis, and John B. Miles

disease may still have vascular compression at the REZ and may benefit from microvascular decompression. When they suffer from bilateral TGN, this nonablative option becomes even more important. Magnetic resonance tomographic angiography provides a reliable preoperative method of identifying this option. References 1. Ballantyne ES , Page RD , Meaney JFN , et al : Coexistent trigeminal neuralgia, hemifacial spasm and hypertension: preoperative imaging of neurovascular compression. Case report. J Neurosurg 80 : 559 – 563 , 1994 Ballantyne ES, Page RD

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Parapontine trigeminal cryptic angiomas presenting as trigeminal neuralgia

Shin-ichi Tsubaki, Takanori Fukushima, Teruaki Tamagawa, Shin-ichiro Miyazaki, Kazuo Watanabe, Nobumasa Kuwana, and Tsuneo Shimizu

I n recent years, vascular compression of the trigeminal nerve root has been regarded as the major cause of tic douloureux, and posterior fossa microvascular decompression has been well established as a definitive treatment of trigeminal neuralgia (TN). 3, 22 We have been treating patients with TN surgically by the posterior fossa route, and in the majority of cases, arteries were found compressing the trigeminal nerve root. In our series of 1257 cases, 119 tumors and 10 vascular malformations were encountered. Three patients had medium to large arteriovenous

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Partial sensory trigeminal rhizotomy at the pons for trigeminal neuralgia

Jacob N. Young and Robert H. Wilkins

N eurosurgeons have developed many procedures to alleviate the pain of medically intractable trigeminal neuralgia. Some of the most impressive results have been obtained by microvascular decompression; although it requires a retromastoid craniectomy, this procedure is capable of producing a high degree and long duration of pain relief while sparing facial sensation. 2–6, 12, 14–17, 22, 26, 27, 31 However, some patients lack evidence of significant vascular contact at the time of posterior fossa exploration. Moreover, it appears that patients with venous

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Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery

Report of two cases

Jin Woo Chang, Jae Young Choi, Young Sul Yoon, Yong Gou Park, and Sang Sup Chung

V ascular compression of the trigeminal nerve at the root entry zone is believed to be the cause of TN in most patients. 11 A wide variety of causes, including an MS plaque at the root entry zone, tumors, aneurysm, and arteriovenous malformation have been reported to produce trigeminal neuralgia. 1, 4, 12 Recently, several authors have reported that infarction of the root entry zone of the trigeminal nerve is a probable cause of TN. 6, 7, 9 In this paper, we describe two patients with TN associated with a pontine lesion and suggest why they may be the

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Gamma knife radiosurgery using 90 Gy for trigeminal neuralgia

Bradley Nicol, William F. Regine, Claire Courtney, Ali Meigooni, Michael Sanders, and Byron Young

radiosurgery as the first surgery for trigeminal neuralgia. Stereotact Funct Neurosurg 70 (Suppl 1) : 187 – 191 , 1998 Kondziolka D, Lunsford LD, Flickinger JC: Gamma knife radiosurgery as the first surgery for trigeminal neuralgia. Stereotact Funct Neurosurg 70 (Suppl 1): 187–191, 1998 9782250 10.1159/000056421 3. Kondziolka D , Lunsford LD , Flickinger JC , et al : Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit. J Neurosurg 84 : 940 – 945 , 1996