✓ A case of von Hippel-Lindau disease is described in which a pituitary hemangioblastoma was present as well as a cerebrovascular anomaly.
Noel G. Dan and Dermer E. Smith
Noel G. Dan and Megan J. Wade
✓ One hundred eighty of 207 consecutive patients with ventricular shunts were studied to determine the incidence of post-shunt epilepsy. Of these 17 (9.4%) developed seizures. The incidence fell from 15.2% in children younger than 1 year to 6.9% in patients over 50 years of age, but age was not statistically significant. Of patients with a parietal ventricular catheterization site only 6.6% had convulsions, in contrast to 54.5% of those with a frontal locus. The incidence of seizures rose with multiple ventricular catheter revisions, but was unrelated to bilaterality of shunting. The risk of seizures fell from 5% in the 1st year after shunting to 1.1% after the 3rd year.
David J. Skirving and Noel G. Dan
Object. The aim of this study was to investigate outcomes and complication rates associated with percutaneous balloon compression (PBC) of the trigeminal ganglion over a long follow-up period.
Methods. This retrospective review was conducted in 496 patients with typical symptoms of unilateral trigeminal neuralgia who underwent 531 PBCs of the trigeminal ganglion between 1980 and 1999. The mean length of follow up was 10.7 years. The treatment used was a modification of that first described by Mullan and Lichtor in 1983.
There were nine technical failures. Of the 522 successful procedures, prompt pain relief ensued in all patients except one. Recurrence of pain was found in 95 patients (19.2%) within 5 years and in 158 patients (31.9%) over the entire study period. Symptomatic dysesthesias occurred in 19 patients (3.8%), but corneal anesthesia and anesthesia dolorosa did not.
Conclusions. In this review the authors present data on the largest cohort of patients with the longest follow up for this procedure in the current literature. The balance between the recurrence rate and troublesome sensory complications achieved in this series is favorable when compared with previously published studies on outcomes of PBC and the two alternative percutaneous methods, radiofrequency thermocoagulation and glycerol rhizolysis. The PBC procedure has additional advantages in that it is relatively straightforward and quick, and can be performed during a brief period of general anesthesia with no discomfort to the patient. This makes it an attractive first choice in the treatment of trigeminal neuralgia.