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Bilateral trigeminal neuralgia: a 14-year experience with microvascular decompression

Ian F. Pollack, Peter J. Jannetta, and David J. Bissonette

B ilateral trigeminal neuralgia (TN) is uncommon, occurring in 1% to 6% of patients with TN in most large series. 1, 7, 10, 13, 16, 18, 34 Although the association of bilateral symptoms with multiple sclerosis has been emphasized by several authors, 13–16, 22, 34 the vast majority of cases are of the so-called “idiopathic” variety. Operative treatment has often been deferred in these individuals because of concerns of producing bilateral trigeminal sensory or motor deficits with ablative procedures. Techniques employed (with varying degrees of success) to

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Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case

Mao Vásquez, Luis J. Saavedra, Hector H. García, Evelyn Vela, Jorge E. Medina, Miguel Lozano, Carlos Hoyos, and William W. Lines-Aguilar

Trigeminal neuralgia (TN) is the most common type of facial pain, negatively affecting quality of life and work capacity in 34% of patients. 1 TN has a prevalence of 4–13 cases per 100,000 inhabitants 1–3 and generally affects patients older than 50 years, with a female-to-male ratio of 1.5 to 1. In primary (classic) TN, compression by vascular loops is found at the entrance of the trigeminal nerve to the brainstem. 4 , 5 In secondary TN, 6 , 7 extrinsic compression of the trigeminal nerve triggers the pain. The most common causes of extrinsic TN are

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Dedicated linear accelerator radiosurgery for the treatment of trigeminal neuralgia

Zachary A. Smith, Antonio A. F. De Salles, Leonardo Frighetto, Bryan Goss, Steve P. Lee, Michael Selch, Robert E. Wallace, Cynthia Cabatan-Awang, and Timothy Solberg

well as a possible primary modality in elderly patients and those who are candidates for more invasive procedures. Abbreviations used in this paper CT = computerized tomography ; LINAC = linear accelerator ; MR = magnetic resonance ; TN = trigeminal neuralgia . References 1. Barker FG II , Jannetta PJ , Bissonette DJ , et al : The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334 : 1077 – 1083 , 1996 Barker FG II

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Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar compression

Mark E. Linskey, Hae Dong Jho, and Peter J. Jannetta

M icrovascular decompression of the trigeminal nerve is an effective operation for the treatment of patients with trigeminal neuralgia, with long-term cure rates reported in 69% to 96% of cases. 3, 4, 6, 15, 22, 26, 27, 36, 44, 47, 49, 55 In most cases, vascular compression is caused by branches of the distal vertebrobasilar trunk or regional veins. Symptomatic trigeminal nerve compression caused by either the vertebral artery (VA) or the basilar artery (BA) has been the subject of many case reports, 7, 8, 11, 14, 16, 18, 19, 28, 30, 32, 33, 39–41, 43, 45, 51

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External carotid artery fistula due to microcompression of the gasserian ganglion for relief of trigeminal neuralgia

Case report

Rogelio Revuelta, Edgar Nathal, Jorge Balderrama, Alejandro Tello, and Marco Zenteno

Microcompression of the gasserian ganglion and other percutaneous injection procedures have been considered successful low-risk procedures for some cases of trigeminal neuralgia; however, there is a small percentage of patients who suffer vascular complications related to these procedures that can lead to morbidity. Venous or arterial bleeding may occur secondary to puncture of venous or arterial structures located near the foramen ovale. 4, 6, 9 The internal carotid artery may also be punctured within the area of the cavernous sinus, causing a carotid-cavernous fistula. 3, 7

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Repeated Gamma Knife surgery for refractory trigeminal neuralgia

Chuan-Fu Huang, Jim-Chao Chuang, Hsien-Tang Tu, and Long-Yau Lin

Authors & Year No. of Cases GKS/Additive 2 nd GKS GKS (mos) (%) (%) (%) Hasegawa, et al., 2002 27 75.6/64.4/148.5 overlapped 50% 20.4 85.2 19 12.7 Shetter, et al., 2002 19 78.2/46.6/124.8 identical 13.5 85 53 42 Herman, et al., 2005 18 75/70/146 identical 24.5 78 45 11 Pollock, et al., 2005 19 81.6/76.1/163.1 retrogasserian 24 95 74 58 present study 28 79/52/132 identical 43 68 43 38 * FU = follow up; med = medicine. References 1 Brisman R : Gamma Knife radiosurgery for primary management for trigeminal neuralgia . J Neurosurg (Suppl 3) 93 : 159 – 161 , 2000 2

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Anesthesia-induced Takotsubo cardiomyopathy in trigeminal neuralgia: illustrative case

Guido Mazzaglia, Giulio Bonomo, Emanuele Rubiu, Paolo Murabito, Alessia Amato, Paolo Ferroli, and Marco Gemma

, trigeminal neuralgia is linked with sudden pain and prolonged suffering that may provoke a physical and psychological stress response. In this paper, we present a case of TS that manifested during induction of anesthesia to perform a surgical microvascular decompression (MVD) of the left trigeminal nerve in a patient with trigeminal neuralgia. We expose the peculiar clinical picture and discuss the possible underlying pathophysiological mechanisms. Illustrative Case We present a case of a 50-year-old female patient scheduled for an MVD who presented immediately

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Treatment of postherpetic trigeminal neuralgia with the Leksell gamma knife

Dušan Urgošík, Josef Vymazal, Vilibald Vladyka, and Roman Liščák

-controlled trial. J Pain Symptom Manage 13: 327–331, 1997 10.1016/S0885-3924(97)00077-8 5. Bullard DE , Nashold BS Jr : The caudalis DREZ for facial pain. Stereotact Funct Neurosurg 68 : 168 – 174 , 1997 Bullard DE, Nashold BS Jr: The caudalis DREZ for facial pain. Stereotact Funct Neurosurg 68: 168–174, 1997 10.1159/000099918 6. Burchiel KJ : Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia. J Neurosurg 69 : 361 – 366 , 1988 Burchiel KJ: Percutaneous

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Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia

Ramiro D. Lobato, Juan J. Rivas, Rosario Sarabia, and Eduardo Lamas

I n the 1950's and 1960's deliberate compression of the gasserian ganglion was performed through an open operation for the treatment of trigeminal neuralgia. 1, 9, 23, 26, 34 Percutaneous mechanical gangliolysis was also performed either by massaging the ganglion with a blunt instrument 13 or by a fairly rapid injection of saline solution into Meckel's cave. 7 It was not until 1983 that Mullan and Lichtor 17 described a safe and effective method for compressing the ganglion using an inflatable balloon. Their preliminary results were promising enough to

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The pathophysiology of trigeminal neuralgia: a molecular review

Bryan Dong, Risheng Xu, and Michael Lim

the human species filter on PubMed and the following combination of keywords: trigeminal neuralgia, genetic, molecular, gene, mutation, channel, and inflammation. The titles and abstracts of articles of interest were individually checked to determine whether the article was an original clinical study investigating a specific pathophysiological mechanism in patients with TN. Articles were also manually checked to ensure a discovery cohort of at least 10 patients. Articles that met these two standards were individually reviewed on a whole-text basis. Articles