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Erschienen in: Acta Neurochirurgica 5/2011

01.05.2011 | Clinical Article

Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression

verfasst von: Wenyao Hong, Xuesheng Zheng, Zhenghai Wu, Xinyuan Li, Xuhui Wang, Yi Li, Wenchuan Zhang, Jun Zhong, Xuming Hua, Shiting Li

Erschienen in: Acta Neurochirurgica | Ausgabe 5/2011

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Abstract

Purpose

To summarize our experience and lessons of microvascular decompression surgery for trigeminal neuralgia caused solely by venous compression.

Methods

Fifteen patients with idiopathic trigeminal neuralgia caused by venous compression only underwent microvascular decompression. The entire course of the trigeminal root was explored thoroughly; and coagulating and cutting techniques were preferred in decompressing the culprit veins. Their clinical features, outcomes and operative complications were analyzed.

Results

The compressing veins included the transverse pontine vein in five cases (33.3%), the transverse pontine vein and the vein of middle cerebellar peduncle in one (6.7%), the transverse pontine vein and the vein of cerebellopontine fissure in one (6.7%), the superior petrosal vein in three (20%), the pontotrigeminal vein in one (6.7%), the vein of the cerebellopontine fissure in two (13.3%), and the plexus venosus or venule in two (13.3%). After microvascular decompression, 11 cases (73.3%) had “excellent” or “good” pain relief. Four cases (26.7%) failed the first surgery; and two of them underwent re-operation and got “excellent” pain relief. Postoperative facial numbness appeared in four cases, due to injury to trigeminal nerve when coagulation.

Conclusion

The transverse pontine vein is the most common offending vein. For this type of trigeminal neuralgia, coagulating and cutting techniques are preferred in decompressing the culprit veins. The entire course of the trigeminal root should be explored and decompressed. Following these principles, excellent or good pain relief could be achieved in most cases; and recurrence is rare. However, sometimes injury to the nerve is unavoidable when coagulating the culprit vein.
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Metadaten
Titel
Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression
verfasst von
Wenyao Hong
Xuesheng Zheng
Zhenghai Wu
Xinyuan Li
Xuhui Wang
Yi Li
Wenchuan Zhang
Jun Zhong
Xuming Hua
Shiting Li
Publikationsdatum
01.05.2011
Verlag
Springer Vienna
Erschienen in
Acta Neurochirurgica / Ausgabe 5/2011
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-011-0957-x

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