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Marc Sindou, José Leston, Evelyne Decullier and François Chapuis

trigeminal neuralgia by the cerebellar route . Ann Surg 96 : 787 – 795 , 1932 12 Gardner WJ : Concerning the mechanism of trigeminal neuralgia and hemifacial spasm . J Neurosurg 19 : 947 – 958 , 1962 13 Gardner WJ , Miklos MV : Response of trigeminal neuralgia to decompression of sensory root. Discussion of cause of trigeminal neuralgia . JAMA 170 : 1773 – 1776 , 1959 14 Hamlyn PJ , King TT : Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study . J Neurosurg 76 : 948 – 954 , 1992 15 Jannetta PJ

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Damianos E. Sakas, Ioannis G. Panourias, George Stranjalis, Maria P. Stefanatou, Nikos Maratheftis and Nikos Bontozoglou

compounded the problem. During procedures for the treatment of GN, the intermediate nerve (sensory branch of the facial nerve) was reported to be compressed by the AICA in some patients. To the best of our knowledge, however, clear and convincing pictorial demonstrations of intraoperative findings of such neurovascular conflict have been very limited. Furthermore, no reports of preoperative neuroimaging studies confirming the neurovascular compression of the intermediate nerve as the primary cause of paroxysmal otalgia have been provided in the literature. Case Report

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Etiology and definitive microsurgical treatment of hemifacial spasm

Operative techniques and results in 47 patients

Peter J. Jannetta, Munir Abbasy, Joseph C. Maroon, Francisco M. Ramos and Maurice S. Albin

decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2 : 217 – 220 , 1970 Jannetta PJ: Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2: 217–220, 1970 12. Jannetta PJ : Neurovascular compression of the facial nerve in hemifacial spasm: relief by microsurgical technique , in Merei FT (ed): Reconstructive Surgery of Brain Arteries . Budapest : Publishing House of the Hungarian Academy of Sciences , 1974 , pp 193 – 199 Jannetta PJ

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Toru Satoh, Keisuke Onoda and Isao Date

patients with hemifacial spasm. The 3D MR cisternogram represents a reconstructed T 2 -weighted 3D FSE sequence, and the 3D MR angiogram is an MR angiogram reconstructed from a 3D TOF SPGR sequence in the steady state. Images of black blood shown on T 2 -weighted FSE MR cisternograms and those of bright blood shown on TOF SPGR MR angiograms were coregistered and composed into a single 3D image by using a graphic computer workstation. With a transparent image of the fused 3D MR cisternogram–angiogram, the site of the neurovascular compression was preoperatively assessed

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Andrew C. Zacest, Stephen T. Magill, Jonathan Miller and Kim J. Burchiel

T rigeminal neuralgia is a neuropathic pain syndrome often associated with neurovascular compression of the trigeminal nerve root entry zone. It has been classified into Type 1 and Type 2 TN subtypes. Type 1 TN is characterized by lancinating, intermittent pain present for more than 50% of the time and Type 2 TN is characterized by a constant pain that is present for more than 50% of the time. 2 It has been suggested that Types 1 and 2 TN may represent the ends of a facial pain or TN spectrum, 1 one in which paroxysmal lancinating pain gives way to a

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Takuro Inoue, Hisao Hirai, Toshiki Shimizu, Masayuki Tsuji, Ayako Shima, Fumio Suzuki and Masayuki Matsuda

O cular neuromyotonia is a rare oculomotor motility disorder characterized by transient paroxysmal diplopia resulting from spontaneous spasm of ocular muscles. 5 , 9 , 16 Although it has been reported as a rare complication after radiation therapy in most cases, 1 , 4 , 5 , 9 , 11 , 12 , 16 , 20 the involvement of neurovascular compression has been suggested in a few cases. 18 , 19 However, the reports suggesting vascular compression are only based on MRI findings. We describe a case of ocular neuromyotonia caused by vascular compression that was

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Daniel K. Resnick and Peter J. Jannetta

M icrovascular decompression (MVD) procedures have been shown to be efficacious for the treatment of a variety of cranial rhizopathies. Trigeminal neuralgia, hemifacial spasm, disabling vertigo, and glossopharyngeal neuralgia have all been demonstrated to respond well (80% long-term cure rates) to MVD. 1, 2, 6, 7 The high success rates associated with these procedures lends credence to the hypothesis that neurovascular compression is a causative factor in these disorders. Recently, one of our patients developed a hyperactive gag response after undergoing MVD of

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Hidenori Ogasawara, Shuichi Oki, Hiroaki Kohno, Seiichiro Hibino and Yoko Ito

by tumor, two different mechanisms might cause symptoms. In a cerebellopontine angle tumor, the tumor directly compresses the fifth and/or seventh nerve. In a posterior fossa tumor not involving the cerebellopontine angle, the tumor compresses and displaces the brainstem directly, causing secondary neurovascular compression of the fifth and seventh nerves (the so-called “remote effect”). Therefore, at operation for painful tic convulsif caused by a posterior fossa tumor not involving the cerebellopontine angle, decompression of the fifth and seventh nerves by

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Juergen Lutz, Niklas Thon, Robert Stahl, Nina Lummel, Joerg-Christian Tonn, Jennifer Linn and Jan-Hinnerk Mehrkens

pons (i.e., root entry zone [REZ]). 24 , 25 , 31 , 32 It is widely believed that direct arterial contact causes pulsatile, repetitive trauma that leads to focal axonal degeneration and demyelination processes within this vulnerable site. 9 , 13 , 25 These structural alterations facilitate ephaptic neurotransmissions that cause pain upon common triggers such as chewing or tactile sensations. 11 Most frequently, neurovascular compression is caused by a direct anatomical relation with the superior cerebellar artery (SCA) (60%–90%), followed by the anterior inferior

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Makoto Oishi, Masafumi Fukuda, Tetsuya Hiraishi, Naoki Yajima, Yosuke Sato and Yukihiko Fujii

surgical procedures. 13 , 15 , 20 , 21 , 26 There are recent reports demonstrating a 3D interactive computer simulation system applicable not only to surveying 3D data visually but also to manipulating data by employing haptic sensations through a specific device. 13 , 15 , 26 Neurovascular compression syndromes, such as trigeminal neuralgia and hemifacial spasm, are defined as hyperactive dysfunctions involving the cranial nerves and have been explained as being caused by anatomical factors including vascular compression of the cranial nerve. 6 The success of MVD