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Microvascular decompression for trigeminal neuralgia caused by trigeminocerebellar artery

Norio Ichimasu, Nobuyuki Nakajima, Ken Matsushima, Michihiro Kohno, and Yutaka Takusagawa

Transcript This video will demonstrate the microvascular decompression for trigeminal neuralgia caused by the trigeminocerebellar artery. 0:29 Clinical History. This 53-year-old woman was presented to our hospital suffering from facial pain on her right side. Her symptoms began 4 years previously and were characterized by an electric shooting pain in the right maxillary division of the trigeminal nerve. The pain was triggered by brushing her teeth or washing her face. The patient was diagnosed with trigeminal neuralgia, and a treatment of oral carbamazepine was

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Right medium-sized vestibular schwannoma with trigeminal neuralgia post-fractionated radiotherapy

Kunal Vakharia, Anthony L. Mikula, Ashley M. Nassiri, Colin L. W. Driscoll, and Michael J. Link

Transcript 0:22 Description of Patient. Here we describe the resection of a right-sided medium vestibular schwannoma with trigeminal neuralgia status post-fractionated radiotherapy. Patient is a 51-year-old female with right-sided V2 trigeminal pain who was found to have a vestibular schwannoma that underwent fractionated radiotherapy with 48.6 Gy in 27 fractions over a 2-month period at an outside institution. She had sharp, persistent, lightening-type pain 6 months after radiotherapy. On exam she had reduced pinprick in V1–V2 down the angle

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Teflon bridge technique for endoscopic-assisted microvascular decompression of ectatic basilar artery and anterior inferior cerebellar artery for trigeminal neuralgia: operative video and technical nuances

James K. Liu and Asif Shafiq

Transcript This is Dr. James Liu, and I will be demonstrating the Teflon bridge technique for endoscopic-assisted microvascular decompression of an ectatic basilar artery and anterior inferior cerebellar artery for trigeminal neuralgia. 0:35 Patient History and Physical Examination. The patient is a 61-year-old female who presented with 12 years of left-sided type 1 trigeminal neuralgia in the V2/V3 region. She had some temporary relief with carbamazepine, but her pain became refractory to medical therapy. Her neurological exam was otherwise intact. 0

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Exoscopic microvascular decompression for hemifacial spasm and trigeminal neuralgia

Hiroki Toda, Hirokuni Hashikata, and Ryota Ishibashi

it onto the left VA using a fibrin-soaked TachoSil again. We confirm the decompression of the facial nerve root exit zone. The tortuous vertebral arteries are detached from the facial nerve, and the VA union remains attached to the dura at the level of the lower cranial nerves 12 months after the surgery. The patient has a gradual resolution of hemifacial spasm postoperatively. A similar technique can mobilize a dolichoectatic VA, causing trigeminal neuralgia. We dissect the elongated VA from the lower cranial, facial, and auditory nerves. We move the VA downward

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Microsurgical resection of unruptured cerebellar arteriovenous malformation presenting with trigeminal neuralgia

Walter Marani, Nicola Montemurro, Shoichiro Tsuji, Paolo Perrini, Kosumo Noda, Nakao Ota, Yu Kinoshita, Hiroyasu Kamiyama, and Rokuya Tanikawa

Transcript 0:20 Clinical Presentation. In this video, we will discuss the surgical treatment of posterior fossa arteriovenous malformation (AVM) in a young patient. The relevant anatomy and technical nuances will also be presented. This is a 24-year-old woman with right trigeminal neuralgia and right upper-limb ataxia associated with a Spetzler-Martin 1 grade III unruptured AVM located in the right cerebellopontine angle (CPA). The trigeminal neuralgia did not improve after medical treatment. Patient refused radiosurgery and endovascular treatment and chose for

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Trigeminal interfascicular neurolysis (nerve combing) for refractory recurrent neuralgia in multiple sclerosis

Paolo Ferroli, Ignazio G. Vetrano, Francesco Acerbi, Gabriella Raccuia, Marco Schiariti, Paolo Confalonieri, Luisa Chiapparini, and Morgan Broggi

recovered in the following months. The patient is pain free without medications at a 1-year follow-up. 3:26 Trigeminal Combing: Indications. Trigeminal combing is indicated for drug-resistant trigeminal neuralgia in multiple sclerosis patients when there is no intraoperative evidence of vascular cross-compression. 2 , 4 , 5 In addition, it is applicable to any trigeminal neuralgia patient without intraoperative evidence of neurovascular compression. 5 , 6 Author Contributions Primary surgeon: Ferroli. Assistant surgeon: Vetrano. Editing and drafting the video and

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Microvascular transposition using Teflon sling technique

Mitchell W. Couldwell, Vance Mortimer, AS, and William T. Couldwell

Transcript This case demonstrates the technique that we use for microvascular transposition for vascular conflict syndromes. 0:28 Microvascular Decompression for Treatment of Trigeminal Neuralgia. This is a 60-year-old woman with left-sided trigeminal neuralgia, primarily in the V2 distribution. You can see there is a conflict of a vessel at the root entry zone of the fifth nerve on the left side. 1 She is placed in the lateral position. For this case, we’ll monitor motor evoked potentials, somatosensory evoked potentials, facial nerve function, and auditory

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Use of a 3D exoscope in microvascular decompression of the trigeminal nerve root

Johannes Herta, Karl Rössler, and Christian Dorfer

Transcript In this video we describe the use of a 3D exoscope and the technical nuances to perform vascular decompression of the trigeminal nerve root in patients suffering from trigeminal neuralgia. 0:34 Patient Positioning. We prefer to operate on the patient in the prone position with the head turned and inclined by approximately 30°, as this allows us to position the patient very steeply. This in turn leads to a very good CSF drainage and a relaxed cerebellum without having to worry about air embolism. Landmarks such as the asterion

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Combined petrosal approach for resection of a large left petroclival meningioma

Francesco Paglia, Lorenzo Giammattei, Paolo di Russo, and Sebastien Froelich

Petroclival meningiomas represent the most complex lesions in skull base surgery, being closely related to critical neurovascular structures. The combined petrosal approach allows a wide exposure of the petroclival region and provides multiple angles of attack, limiting brain retraction.

The authors present the case of a 54-year-old man with a large left petroclival meningioma responsible for headaches, dysphagia, and trigeminal neuralgia. The lesion was resected using a combined petrosal approach. A progressive improvement of the preoperative symptoms was observed. Postoperative MRI showed a near-total resection of the tumor, along with reexpansion of the brainstem.

The video can be found here:

Open access

Combined transpetrosal approach for giant petroclival meningioma: 2-dimensional operative video

Vera Vigo, Karam Asmaro, Maximiliano A. Nuñez, Ahmed Moyheldin, Robert K. Jackler, and Juan C. Fernandez-Miranda

Petroclival meningiomas are extremally challenging lesions due to their deep location and close relation to critical neurovascular structures. Several approaches have been described to achieve gross-total resection with low morbidity and mortality. In this 2-dimensional operative video, the authors show a simultaneous combined transpetrosal approach. The patient is a 44-year-old woman with an 8-month history of gait imbalance with evidence of a giant petroclival meningioma on neuroimaging. She underwent a combined middle fossa approach with anterior petrosectomy and retrosigmoid/retrolabyrinthine approach to achieve gross-total tumor resection. The postoperative course was characterized by trigeminal neuralgia, and neuroimaging showed gross-total resection of the tumor.

The video can be found here: