scholarly journals Trigeminocardiac reflex unresponsive to atropine during microvascular decompression of trigeminal nerve root:A potentially lethal complication of a simple surgery

2007 ◽  
Vol 13 (6) ◽  
pp. 33-35
Author(s):  
V Ahuja
Keyword(s):  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Trigeminocardiac Reflex

scholarly journals Microvascular decompression for trigeminal neuralgia caused by trigeminocerebellar artery

2020 ◽  
Vol 3 (2) ◽  
pp. V4
Author(s):  
Norio Ichimasu ◽  
Nobuyuki Nakajima ◽  
Ken Matsushima ◽  
Michihiro Kohno ◽  
Yutaka Takusagawa
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Basilar Artery ◽  
Microvascular Decompression ◽  
Nerve Root ◽  
Cerebellar Hemisphere ◽  
Link Type ◽  
Trigeminal Nerve Root ◽  
Close Relationship

In this operative video, the authors demonstrate the case of a 53-year-old woman who presented with typical right trigeminal neuralgia by a trigeminocerebellar artery (TCA). The TCA was first defined by Marinković as a unique branch of the basilar artery supplying both the trigeminal nerve root and the cerebellar hemisphere. As a result of the close relationship between this vessel and the nerve root, the TCA might compress the nerve root, thereby causing trigeminal neuralgia. However, few cases of trigeminal neuralgia caused by TCA have been reported. This video shows the microvascular decompression for trigeminal neuralgia by the TCA.The video can be found here: https://youtu.be/UnGsCQRK6aY

Trigeminal Neuralgia Caused by Venous Compression

Neurosurgery ◽  
2004 ◽  
Vol 55 (2) ◽  
pp. 334-339 ◽  
Author(s):  
Toshio Matsushima ◽  
Phuong Huynh-Le ◽  
Masayuki Miyazono
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Complete Relief ◽  
Surgical Results ◽  
Meckel’S Cave ◽  
Trigeminal Pain ◽  
Venous Compression ◽  
Facial Numbness ◽  
Meckel's Cave

Abstract OBJECTIVE: The purpose of this study is to clarify whether venous compression on the trigeminal nerve really causes trigeminal neuralgia or not, and to identify which veins are the offending veins. METHODS: We used microvascular decompression in operations on 121 patients with typical trigeminal neuralgia. We analyzed the intraoperative findings and surgical results in these 121 cases. RESULTS: In 7 of the 121 cases, only the vein was identified as a compressive factor on the trigeminal nerve. In 6 of these 7 cases, single venous compression was found, whereas the remaining case had two offending veins. The transverse pontine vein was most frequently found as the offending vein near Meckel's cave. All patients showed complete relief of trigeminal pain after decompression of the veins, but four of them developed facial numbness after surgery, which tended to be slight and did not require any treatment. CONCLUSION: Our surgical experiences showed that venous compression could cause trigeminal neuralgia by itself and that the transverse pontine vein should be carefully observed because it is most frequently the offending vein.

scholarly journals Microvascular decompression for the treatment of neurogenic hypertension with trigeminal neuralgia

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenchao Lu ◽  
Hui Wang ◽  
Zhongnan Yan ◽  
Yuangang Wang ◽  
Hongmin Che
Keyword(s):  
Blood Pressure ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Effective Rate ◽  
Ventrolateral Medulla ◽  
Control Group ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Experimental Group

Abstract Background To evaluate the efficacy of microvascular decompression (MVD) in reducing hypertension (HTN) in hypertensive patients with trigeminal neuralgia (TN). Methods The clinical data of 58 cases of neurogenic HTN with TN treated in our hospital were retrospectively reviewed. Preoperative MR revealed abnormal blood pressure in the left rostral ventrolateral medulla (RVLM) and the posterior cranial nerve root entry zone (REZ). The patients were divided into control group: only trigeminal nerve was treated with MVD; experimental group: trigeminal nerve, RVLM and REZ were treated with MVD at the same time. The patients were followed up for 6 months to 1 year to observe the changes of blood pressure. Results There was no significant difference in gender, age, course of TN, course of HTN, grade of HTN and preoperative blood pressure between the two groups. After operation, the effective rate of HTN improvement with MVD was 32.1% in the control group. There was no significant difference in the preoperative and post operative blood pressure. (P△SBP = 0.131; P△BDP = 0.078). In the experimental group, the effective rate was 83.3%. The postoperative blood pressure was significantly lower than preoperative values. (P△SBP < 0.001; P△DBP < 0.001). Conclusions MVD is an effective treatment for neurogenic HTN. However, the criteria for selecting hypertensive patients who need MVD to control their HTN still needs to be further determined. Possible indications may include: left trigeminal neuralgia, neurogenic HTN; abnormal blood pressure compression in the left RVLM and REZ areas on MR; and blood pressure in these patients can not be effectively controlled by drugs.

scholarly journals Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia

2017 ◽  
Vol 126 (5) ◽  
pp. 1691-1697 ◽  
Author(s):  
Debebe Theodros ◽  
C. Rory Goodwin ◽  
Matthew T. Bender ◽  
Xin Zhou ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Pain Control ◽  
Surgical Intervention ◽  
Patient Records ◽  
Duration Of Symptoms ◽  
Facial Numbness ◽  
Lancinating Pain

OBJECTIVETrigeminal neuralgia (TN) is characterized by intermittent, paroxysmal, and lancinating pain along the distribution of the trigeminal nerve. Microvascular decompression (MVD) directly addresses compression of the trigeminal nerve. The purpose of this study was to determine whether patients undergoing MVD as their first surgical intervention experience greater pain control than patients who undergo subsequent MVD.METHODSA retrospective review of patient records from 1998 to 2015 identified a total of 942 patients with TN and 500 patients who underwent MVD. After excluding several cases, 306 patients underwent MVD as their first surgical intervention and 175 patients underwent subsequent MVD. Demographics and clinicopathological data and outcomes were obtained for analysis.RESULTSIn patients who underwent subsequent MVD, surgical intervention was performed at an older age (55.22 vs 49.98 years old, p < 0.0001) and the duration of symptoms was greater (7.22 vs 4.45 years, p < 0.0001) than for patients in whom MVD was their first surgical intervention. Patients who underwent initial MVD had improved pain relief and no improvement in pain rates compared with those who had subsequent MVD (95.8% and 4.2% vs 90.3% and 9.7%, respectively, p = 0.0041). Patients who underwent initial MVD had significantly lower rates of facial numbness in the pre- and postoperative periods compared with patients who underwent subsequent MVD (p < 0.0001). The number of complications in both groups was similar (p = 0.4572).CONCLUSIONSThe results demonstrate that patients who underwent other procedures prior to MVD had less pain relief and a higher incidence of facial numbness despite rates of complications similar to patients who underwent MVD as their first surgical intervention.

scholarly journals Prenatal nicotine exposure enhances the trigeminocardiac reflex via serotonin receptor facilitation in brainstem pathways

2013 ◽  
Vol 115 (4) ◽  
pp. 415-421 ◽  
Author(s):  
C. Gorini ◽  
H. Jameson ◽  
A. L. Woerman ◽  
D. C. Perry ◽  
D. Mendelowitz
Keyword(s):  
Receptor Antagonist ◽  
Trigeminal Nerve ◽  
Serotonin Receptor ◽  
Nucleus Ambiguus ◽  
Nicotine Exposure ◽  
Sprague Dawley ◽  
Trigeminocardiac Reflex ◽  
Brainstem Slice ◽  
Prenatal Nicotine Exposure ◽  
Prenatal Nicotine

In this study we used a rat model for prenatal nicotine exposure to test whether clinically relevant concentrations of brain nicotine and cotinine are passed from dams exposed to nicotine to her pups, whether this changes the trigeminocardiac reflex (TCR), and whether serotonergic function in the TCR brainstem circuitry is altered. Pregnant Sprague-Dawley dams were exposed to 6 mg·kg−1·day−1of nicotine via osmotic minipumps for the duration of pregnancy. Following birth dams and pups were killed, blood was collected, and brain nicotine and cotinine levels were measured. A separate group of prenatal nicotine-exposed pups was used for electrophysiological recordings. A horizontal brainstem slice was obtained by carefully preserving the trigeminal nerve with fluorescent identification of cardiac vagal neurons (CVNs) in the nucleus ambiguus. Stimulation of the trigeminal nerve evoked excitatory postsynaptic current in CVNs. Our data demonstrate that prenatal nicotine exposure significantly exaggerates both the TCR-evoked changes in heart rate in conscious unrestrained pups, and the excitatory neurotransmission to CVNs upon trigeminal afferent nerve stimulation within this brainstem reflex circuit. Application of the 5-HT1Areceptor antagonist WAY 100635 (100 μM) and 5-HT2A/Creceptor antagonist ketanserin (10 μM)significantly decreased neurotransmission, indicating an increased facilitation of 5-HT function in prenatal nicotine-exposed animals. Prenatal nicotine exposure enhances activation of 5-HT receptors and exaggerates the trigeminocardiac reflex.

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