Improving the accuracy of pre-operative evaluation of neurovascular conflict in trigeminal neuralgia using magnetic resonance subtraction

2021 ◽  
Author(s):  
Zhenhong Liao ◽  
Linbo Zou ◽  
Wei Peng ◽  
Bing Ming ◽  
Yong Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Neurovascular Conflict ◽  
Operative Evaluation

scholarly journals Refractory cluster-tic syndrome: The Hickam’s dictum

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Membrilla JA ◽  
◽  
Díaz de Terán J ◽  
Keyword(s):  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Cluster Headache ◽  
Medical Treatment ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Neurovascular Conflict ◽  
Surgical Exploration ◽  
Keywords Trigeminal Neuralgia ◽  
The Right

A 50-year-old man debuted with right trigeminal neuralgia. In the following years, it became refractory to medical treatment and ipsilateral cluster headache appeared. He was diagnosed with cluster-tic syndrome. A brain magnetic resonance with high-spatialresolution 3D T2 sequences (FIESTA) excluded the existence of neurovascular conflict, but a surgical exploration was indicated due to its torpid evolution. A venous contact with the right trigeminal nerve was confirmed in the surgery and microvascular decompression was performed. The patient’s evolution was favorable, improving the trigeminal neuralgia as well as the cluster headache. Keywords: Trigeminal neuralgia; cluster headache; cluster-tic syndrome; microvascular decompression.

PREDICTION OF SURGICAL VIEW OF NEUROVASCULAR DECOMPRESSION USING INTERACTIVE COMPUTER GRAPHICS

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 121-129 ◽  
Author(s):  
Taichi Kin ◽  
Hiroshi Oyama ◽  
Kyousuke Kamada ◽  
Shigeki Aoki ◽  
Kuni Ohtomo ◽  
...  
Keyword(s):  
Steady State ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Computer Graphics ◽  
Trigeminal Neuralgia ◽  
Interactive Visualization ◽  
Fast Imaging ◽  
Neurovascular Compression ◽  
Visualization Method ◽  
Facial Spasm

ABSTRACT OBJECTIVE To assess the value of an interactive visualization method for detecting the offending vessels in neurovascular compression syndrome in patients with facial spasm and trigeminal neuralgia. Computer graphics models are created by fusion of fast imaging employing steady-state acquisition and magnetic resonance angiography. METHODS High-resolution magnetic resonance angiography and fast imaging employing steady-state acquisition were performed preoperatively in 17 patients with neurovascular compression syndromes (facial spasm, n = 10; trigeminal neuralgia, n = 7) using a 3.0-T magnetic resonance imaging scanner. Computer graphics models were created with computer software and observed interactively for detection of offending vessels by rotation, enlargement, reduction, and retraction on a graphic workstation. Two-dimensional images were reviewed by 2 radiologists blinded to the clinical details, and 2 neurosurgeons predicted the offending vessel with the interactive visualization method before surgery. Predictions from the 2 imaging approaches were compared with surgical findings. The vessels identified during surgery were assumed to be the true offending vessels. RESULTS Offending vessels were identified correctly in 16 of 17 patients (94%) using the interactive visualization method and in 10 of 17 patients using 2-dimensional images. These data demonstrated a significant difference (P = 0.015 by Fisher's exact method). CONCLUSION The interactive visualization method data corresponded well with surgical findings (surgical field, offending vessels, and nerves). Virtual reality 3-dimensional computer graphics using fusion magnetic resonance angiography and fast imaging employing steady-state acquisition may be helpful for preoperative simulation.

Association between Trigeminal Neuralgia and Multiple Sclerosis: Role of Magnetic Resonance Imaging

2021 ◽  
Vol 15 (6) ◽  
pp. 1927-1930
Author(s):  
Tahir Baig ◽  
Adnan Ahmed ◽  
Atif Hussain ◽  
Rabia Shah ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Wilcoxon Test ◽  
P Value ◽  
World Population ◽  
Resonance Imaging ◽  
Affected Side

Background: Trigeminal neuralgia (TN) is a severe neuropathic unilateral facial pain affecting about 30% percent of the world population. Neuropathic pains are considered to be associated with multiple sclerosis (MS).Multiple sclerosis is a chronic inflammatory condition causing demyelination and degeneration of axons in central nervous system. Objective: The objective of the study is to determine role of Magnetic Resonance Imaging to find association between trigeminal neuralgia and multiple sclerosis. Methods: The prospective cohort study was conducted for six months in Radiology Department of Hayatabad Medical Complex, Peshawar from September 2020 to February 2021. Initially 250 patients were screened for multiple sclerosis. The study recruited a total of 35 patients of MS visited neuroradiology department, out of which 26 patients were enrolled in the study. The participants with age of 18 years and onward of both genders with definitive symptoms of TN with MS that is having unilateral TN pain (that is sharp shooting electric pulse like) lasting for up-to 2minutes precipitated with an environmental stimulus were included in the study. The patients (n=6) with bilateral MS with TN and cognitive disturbances (n=3) were excluded from the study. Results: The study recruited a total of 26 participants with MS related TN. The clinical examination didn’t show any difference between the three groups with the p-value less than 0.001. Age at the onset of MS was younger in patients with MS related sensory disturbances compared to other two groups, with p-value less than 0.05. The frequency of the affected side was different in all three groups with the p-value less than 0.05 as tested by Fischer exact test. Trigeminal reflex tests done for different components such as R1 and SP1 showed longer latency periods for the affected side after stimulation and unaffected side after stimulation with the mean of 14.2± 4.4 and 15.3±3.2, 16.3±4.2 and 17.4±5.2ms and p-value less than 0.001 as shown by Wilcoxon test. Conclusion: The study showed significant association between trigeminal neuralgia and multiple sclerosis with the greater efficacy of using MRI as imaging technique to find this association. Keywords: Multiple sclerosis, Magnetic Resonance Imaging, Trigeminal neuralgia

Comparison of Clinical Symptoms and Magnetic Resonance Angiographic (MRA) Results in Patients with Trigeminal Neuralgia and Persistent Idiopathic Facial Pain. Medium-Term Outcome after Microvascular Decompression of Cases with Positive MRA Findings

Cephalalgia ◽  
2006 ◽  
Vol 26 (3) ◽  
pp. 266-276 ◽  
Author(s):  
A Kuncz ◽  
E Vörös ◽  
P Barzó ◽  
J Tajti ◽  
P Milassin ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Facial Pain ◽  
Clinical Symptoms ◽  
Vascular Compression ◽  
Term Outcome ◽  
Persistent Idiopathic Facial Pain ◽  
Venous Compression ◽  
Imaging Results

To evaluate whether NC could be demonstrated preoperatively, high-resolution magnetic resonance angiography (MRA) was performed in 287 consecutive patients with TN and persistent idiopathic facial pain (PIFP) on a 0.5-T and a 1-T MR unit. Depending on the clinical symptoms, the TN cases were divided into typical TN and trigeminal neuralgia with non-neuralgic interparoxysmal pain (TNWIP) groups. Microvascular decompression (MVD) was performed in 103 of the MRA-positive cases. The patients were followed up postoperatively for from 1 to 10 years. The clinical symptoms were compared with the imaging results. The value of MRA was assessed on the basis of the clinical symptoms and surgical findings. The outcome of MVD was graded as excellent, good or poor. The clinical symptoms were compared with the type of vascular compression and the outcome of MVD. The MRA image was positive in 161 (56%) of the 287 cases. There were significant differences between the clinical groups: 66.5% of the typical TN group, 47.5% of the TNWIP group and 3.4% of the PIFP group were positive. The quality of the MR unit significantly determined the ratio of positive/negative MRA results. The surgical findings corresponded with the MRA images. Six patients from the MRA-negative group were operated on for selective rhizotomy and no NC was found. Venous compression of the trigeminal nerve was observed in a significantly higher proportion in the background of TNWIP than in that of typical TN on MRA imaging (24.1% and 0.8%, respectively) and also during MVD (31.2% and 1.2%, respectively). Four years following the MVD, 69% of the patients gave an excellent, 23% a good and 8% a poor result. The rate of some kind of recurrence of pain was 20% in the typical TN and 44% in TNWIP group. The rate of recurrence was 57% when pure venous compression was present. The only patient who was operated on from the PIFP group did not react to the MVD. The clinical symptoms and preoperative MRA performed by at least a 1-T MR unit furnish considerable information, which can play a role in the planning of the treatment of TN.

scholarly journals Persistent trigeminal artery: angio-tomography and angio-magnetic resonance finding

2009 ◽  
Vol 67 (3b) ◽  
pp. 882-885 ◽  
Author(s):  
Lícia Pachêco Pereira ◽  
Lara A.M. Nepomuceno ◽  
Pablo Picasso Coimbra ◽  
Sabino Rodrigues de Oliveira Neto ◽  
Marcelo Ricardo C. Natal
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Trigeminal Neuralgia ◽  
Basilar Artery ◽  
Internal Carotid ◽  
Incidental Finding ◽  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Magnetic Resonance Finding

The trigeminal artery (TA) is the most common embryonic carotid-vertebrobasilar anastomosis to persist into adulthood. It typically extends from the internal carotid artery to the basilar artery. Persistent primitive arteries are usually found incidentally, but are often associated with vascular malformation, cerebral aneurysm and, in case of TA, with trigeminal neuralgia. We present one patient with TA as a cause of trigeminal neuralgia and in other three as an incidental finding, on TC and MR angiograms.

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