Journal of Yeungnam Medical Science

Original articles

Personal experience with microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia: Jung Hwan Lee, Jae Meen Lee, Chang Hwa Choi; Yeungnam Univ J Med. 2021;38(3):202-207. Published online November 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00745

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Background
Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN.
Methods
A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any.
Results
The mean follow-up duration was 43.2 months (range, 3–216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%.
Conclusion
The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.

Citations

Citations to this article as recorded by

Revisiting the Efficacy of Redo Microvascular Decompression for Trigeminal Neuralgia
Zhongding Zhang, Hua Zhao, Yinda Tang, Baimiao Wang, Qing Yuan, Ying Zhang, Yihua Li, Jun Zhong, Shiting Li
World Neurosurgery.2024; 186: e335. CrossRef
A systematic review on the efficacy of adjunctive surgical strategies during microvascular decompression for trigeminal neuralgia without intraoperative evidence of neurovascular conflict
Nicola Montano, Grazia Menna, Alessandra Musarra, Renata Martinelli, Alessandro Izzo, Quintino Giorgio D’Alessandris, Manuela D’Ercole, Alessandro Olivi
Neurosurgical Review.2024;[Epub] CrossRef
Progress in Surgical Treatment of Trigeminal Neuralgia
滨何
Advances in Clinical Medicine.2023; 13(02): 2313. CrossRef
How Far Has Radiofrequency Thermocoagulation Come Along as a Treatment Procedure in Treating Trigeminal Neuralgia Patients?
Stephen D Howard, Varun Soti
Cureus.2023;[Epub] CrossRef
Historical aspects of the problem of treatment of trigeminal neuralgia and the role of neurosurgical methods in its solution (literature review)
A. N. Zhurkin, A. V. Semenov, V. A. Sorokovikov, N. V. Bartul
Acta Biomedica Scientifica.2021; 6(4): 123. CrossRef
Trigeminal Neuralgia: Current Approaches and Emerging Interventions
Risheng Xu, Michael E Xie, Christopher M Jackson
Journal of Pain Research.2021; Volume 14: 3437. CrossRef

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms: Jae Young Choi, Chang Hwa Choi, Jun Kyeung Ko, Jae Il Lee, Chae Wook Huh, Tae Hong Lee; Yeungnam Univ J Med. 2019;36(3):208-218. Published online April 25, 2019; DOI: https://doi.org/10.12701/yujm.2019.00192

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Abstract PDF

Background
The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms.
Methods
From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed.
Results
Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only three aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, five (6.9%) remnant neck, and one (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of eight asymptomatic and two symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included one major and three minor recanalizations.
Conclusion
Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

Citations

Citations to this article as recorded by

Adverse events during endovascular treatment of ruptured aneurysms: A prospective nationwide study on subarachnoid hemorrhage in Sweden
Bryndís Baldvinsdóttir, Paula Klurfan, Johanna Eneling, Elisabeth Ronne-Engström, Per Enblad, Peter Lindvall, Helena Aineskog, Steen Friðriksson, Mikael Svensson, Peter Alpkvist, Jan Hillman, Erik Kronvall, Ola G. Nilsson
Brain and Spine.2023; 3: 102708. CrossRef
Microsurgical Clipping versus Advanced Endovascular Treatment of Unruptured Middle Cerebral Artery Bifurcation Aneurysms After a “Coil-First” Policy
Muriel Pflaeging, Christoph Kabbasch, Marc Schlamann, Lenhard Pennig, Stephanie Theresa Juenger, Jan-Peter Grunz, Marco Timmer, Gerrit Brinker, Roland Goldbrunner, Boris Krischek, Lukas Goertz
World Neurosurgery.2021; 149: e336. CrossRef

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