The Epidemiology, Cause, and Prognosis of Painful Tic Convulsif Syndrome: An Individual Patient Data Analysis of 192 Cases

2020 ◽  
Author(s):  
Zixiao Yin ◽  
Yuye Liu ◽  
Yutong Bai ◽  
Hua Zhang ◽  
Huanguang Liu ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Posterior Inferior Cerebellar Artery ◽  
Open Science ◽  
Older Age ◽  
Cochrane Library ◽  
Anterior Inferior Cerebellar Artery ◽  
Vascular Compression ◽  
Vertebrobasilar Artery ◽  
Cerebellar Artery ◽  
Painful Tic Convulsif

Abstract Background Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity not yet been systematically studied.Objective To systematically explore the epidemiology, cause, prognosis, and prognosis predictors of PTC.Method We searched PubMed, Web of Science, and the Cochrane Library for relevant studies published between the library establishment time and July 1st, 2020. Information on demographics, causes, specific interventions, and intervention outcomes was extracted. We first made descriptive analyses for demographics, causes, and surgical outcomes of PTC. Univariate and multivariate regression methods were utilized to explore potential prognosis predictors. Further, a two-step meta-analysis method was employed to validate the identified factors.Results Overall, 57 reports including 192 cases with PTC were included in the analysis. The median age of PTC patient is 54 (44-62), with more patients being female (p < 0.001), initiated as HFS (p = 0.005), and affected left side (p = 0.045). Vertebrobasilar artery (VBA) contributes to over-65% of the causes of single vascular compression for PTC. Anterior inferior cerebellar artery (AICA)/posterior inferior cerebellar artery (PICA) involvement (OR = 4.050, 95% CI = 1.091-15.031) and older age (p = 0.008) predicts symptom-free and recurrence after microvascular decompression (MVD), respectively.Conclusions PTC more occurs in middle-age women between 40 to 60, initiates as HFS, and affects left side. VBA compression is the most common single cause for PTC. MVD could effectively treat PTC with an over-80% cure rate. AICA/PICA involvement predicts successful surgery and older age predicts recurrence.Registration: the protocol of this study is registered in the Open Science Framework (DOI 10.17605/OSF.IO/X9G3R) on July 10th, 2020.

Microvascular decompression for hemifacial spasm

1991 ◽  
Vol 75 (3) ◽  
pp. 388-392 ◽  
Author(s):  
Shinji Nagahiro ◽  
Akira Takada ◽  
Yasuhiko Matsukado ◽  
Yukitaka Ushio
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Anterior Inferior Cerebellar Artery ◽  
Vascular Compression ◽  
Content Type ◽  
Seventh Cranial Nerve ◽  
Cerebellar Artery

✓ To determine the causative factors of unsuccessful microvascular decompression for hemifacial spasm, the follow-up results in 53 patients were assessed retrospectively. The mean follow-up period was 36 months. There were 32 patients who had compression of the seventh cranial nerve ventrocaudally by an anterior inferior cerebellar artery (AICA) or a posterior inferior cerebellar artery. Of these 32 patients, 30 (94%) had excellent postoperative results. Of 14 patients with more severe compression by the vertebral artery, nine (64%) had excellent results, three (21%) had good results, and two (14%) had poor results; in this group, three patients with excellent results experienced transient spasm recurrence. There were seven patients in whom the meatal branch of the AICA coursed between the seventh and eighth cranial nerves and compressed the dorsal aspect of the seventh nerve; this was usually associated with another artery compressing the ventral aspect of the nerve (“sandwich-type” compression). Of these seven patients, five (71%) had poor results including operative failure in one and recurrence of spasm in four. The authors conclude that the clinical outcome was closely related to the patterns of vascular compression.

Neurovascular compression findings in hemifacial spasm

2008 ◽  
Vol 109 (3) ◽  
pp. 416-420 ◽  
Author(s):  
Mauricio Campos-Benitez ◽  
Anthony M. Kaufmann
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Nerve Root ◽  
Posterior Inferior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Vascular Compression ◽  
Neurovascular Compression ◽  
Exit Point ◽  
Root Exit Zone ◽  
Cerebellar Artery

Object It is generally accepted that hemifacial spasm (HFS) is caused by pulsatile vascular compression upon the facial nerve root exit zone. This 2–3 mm area, considered synonymous with the Obersteiner–Redlich zone, is a transition zone (TZ) between central and peripheral axonal myelination that is situated at the nerve's detachment from the pons. Further proximally, however, the facial nerve is exposed on the pontine surface and emerges from the pontomedullary sulcus. The incidence and significance of neurovascular compression upon these different segments of the facial nerve in patients with HFS has not been previously reported. Methods The nature of neurovascular compression was determined in 115 consecutive patients undergoing their first microvascular decompression (MVD) for HFS. The location of neurovascular compression was categorized to 1 of 4 anatomical portions of the facial nerve: RExP = root exit point; AS = attached segment; RDP = root detachment point that corresponds to the TZ; and CP = distal cisternal portion. The severity of compression was defined as follows: mild = contact without indentation of nerve; moderate = indentation; and severe = deviation of the nerve course. Success in alleviating HFS was documented by telephone interview conducted at least 24 months following MVD surgery. Results Neurovascular compression was found in all patients, and the main culprit was the anterior inferior cerebellar artery (in 43%), posterior inferior cerebellar artery (in 31%), vertebral artery (in 23%), or a large vein (in 3%). Multiple compressing vessels were found in 38% of cases. The primary culprit location was at RExP in 10%, AS in 64%, RDP in 22%, and CP in 3%. The severity of compression was mild in 27%, moderate in 61%, and severe in 12%. Failure to alleviate HFS occurred in 9 cases, and was not related to compression location, severity, or vessel type. Conclusions The authors observed that culprit neurovascular compression was present in all cases of HFS, but situated at the RDP or Obersteiner–Redlich zone in only one-quarter of cases and rarely on the more distal facial nerve root. Since the majority of culprit compression was found more proximally on the pontine surface or even pontomedullary sulcus origin of the facial nerve, these areas must be effectively visualized to achieve consistent success in performing MVD for HFS.

Microvascular Decompression for Glossopharyngeal Neuralgia Through the Transcondylar Fossa (Supracondylar Transjugular Tubercle) Approach

2010 ◽  
Vol 66 (suppl_2) ◽  
pp. ons275-ons280 ◽  
Author(s):  
Masatou Kawashima ◽  
Toshio Matsushima ◽  
Tooru Inoue ◽  
Toshihiro Mineta ◽  
Jun Masuoka ◽  
...  
Keyword(s):  
Microvascular Decompression ◽  
Posterior Inferior Cerebellar Artery ◽  
Glossopharyngeal Nerve ◽  
Glossopharyngeal Neuralgia ◽  
Anterior Inferior Cerebellar Artery ◽  
Vascular Compression ◽  
Surgical Results ◽  
Vagus Nerves ◽  
Cerebellar Artery ◽  
Offending Artery

Abstract OBJECTIVE Our surgical results were reviewed to clarify the cause of glossopharyngeal neuralgia (GPN) and the effects of the microvascular decompression (MVD) procedure. METHODS Fourteen cases of idiopathic GPN were operated on through the transcondylar fossa (supracondylar transjugular tubercle) approach. Their clinical data and operative records were retrospectively reviewed. RESULTS In every case, vascular compression on the glossopharyngeal nerve was found and MVD was performed without any major complications. In 13 of the 14 cases the neuralgia completely disappeared postoperatively. Recurrence of pain was found in 1 case. Offending vessels were the posterior inferior cerebellar artery (PICA) in 10 cases, the anterior inferior cerebellar artery (AICA) in 2 cases, and both arteries in 2 cases. In 10 of the 14 cases, the high-origin PICA formed an upward loop between the glossopharyngeal and vagus nerves, compressing the glossopharyngeal nerve upward. In those cases, the PICA was transposed and fixed to the dura mater by the stitched sling retraction technique, and MVD was very effective. CONCLUSION The offending artery was the PICA in most cases. MVD is expected to be very effective, especially when the radiological images show the following 3 findings: 1) high-origin PICA, 2) the PICA making an upward loop, and 3) the PICA coursing the supraolivary fossette. The transcondylar fossa approach is suitable for transposing the PICA by the stitched sling retraction technique, and provides sufficient surgical results.

Hemifacial Spasm: Endoscopic Vascular Decompression

1997 ◽  
Vol 117 (4) ◽  
pp. 308-314 ◽  
Author(s):  
J. Magnan ◽  
F. Caces ◽  
P. Locatelli ◽  
A. Chays
Keyword(s):  
Hemifacial Spasm ◽  
Marked Improvement ◽  
Cerebellopontine Angle ◽  
Posterior Inferior Cerebellar Artery ◽  
Endoscopic Examination ◽  
Anterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
The Mean ◽  
Vascular Decompression

Sixty patients with primitive hemifacial spasm were treated by means of a minimally invasive retrosigmoid approach in which endoscopic and microsurgical procedures were combined. Intraoperative endoscopic examination of the cerebellopontine angle showed that for 56 of the patients vessel-nerve conflict was the cause of hemifacial spasm. The most common offending vessel was the posterior inferior cerebellar artery (39 patients), next was the vertebral artery (23 patients), and last was the anterior inferior cerebellar artery (16 patients). Nineteen of the patients had multiple offending vascular loops. In one patient, another cause of hemifacial spasm was an epidermoid tumor of the cerebellopontine angle. For three patients, it was not possible to determine the exact cause of the facial disorder. Follow-up information was reviewed for 54 of 60 patients; the mean follow-up period was 14 months. Fifty of the patients were in the vessel-nerve conflict group. Forty of the 50 were free of symptoms, and four had marked improvement. The overall success rate was 88%, and there was minimal morbidity (no facial palsy, two cases of severe hearing loss).

scholarly journals Parent Artery Occlusion for Intracranial Aneurysms

2009 ◽  
Vol 15 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Lishan Cui ◽  
Qiang Peng ◽  
Wenbo Ha ◽  
Dexiang Zhou ◽  
Yang Xu
Keyword(s):  
Cerebral Artery ◽  
Intracranial Aneurysms ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebral Aneurysms ◽  
Artery Occlusion ◽  
Anterior Inferior Cerebellar Artery ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Dissecting Aneurysms

Peripheral cerebral aneurysms are difficult to treat with preservation of the parent arteries. We report the clinical and angiographic outcome of 12 patients with cerebral aneurysms located peripherally. In the past five years, 12 patients, six females and six males, presented at our institution with intracranial aneurysms distal to the circle of Willis and were treated endovascularly. The age of our patients ranged from four to 58 years with a mean age of 37 years. Seven of the 12 patients had subarachnoid and/or intracerebral hemorrhage upon presentation. Two patients with P2 dissecting aneurysms presented with mild hemiparesis and hypoesthesia, one patient with a large dissecting aneurysm complained of headaches and two patients with M3 dissecting aneurysms had mild hemiparesis and hypoesthesia of the right arm. Locations of the aneurysms were as follows: posterior cerebral artery in seven patients, anterior inferior cerebellar artery in two, posterior inferior cerebellar artery in one, middle cerebral artery in two. Twelve patients with peripheral cerebral aneurysms underwent parent artery occlusion (PAO). PAO was performed with detachable coils. No patient developed neurologic deficits. Distally located cerebral aneurysms can be treated with parent artery occlusion when selective embolization of the aneurysmal sac with detachable platinum coils or surgical clipping cannot be achieved.

Treatment of an Anterior Inferior Cerebellar Artery Aneurysm With Microsurgical Trapping and In Situ Posterior Inferior Cerebellar Artery to Anterior Inferior Cerebellar Artery Bypass: Case Report

2017 ◽  
Vol 15 (4) ◽  
pp. 418-424 ◽  
Author(s):  
Bryan S Lee ◽  
Alex M Witek ◽  
Nina Z Moore ◽  
Mark D Bain
Keyword(s):  
Artery Bypass ◽  
Posterior Inferior Cerebellar Artery ◽  
Significant Risk ◽  
Artery Aneurysm ◽  
Lateral Approach ◽  
Anterior Inferior Cerebellar Artery ◽  
Parent Vessel ◽  
Cerebellar Artery ◽  
Far Lateral Approach

Abstract BACKGROUND Anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can involve microsurgical and/or endovascular techniques. Such treatment can be challenging and may carry a significant risk of neurological morbidity. OBJECTIVE To demonstrate a case involving a complex AICA aneurysm that was treated with a unique microsurgical approach involving trapping the aneurysm and performing in Situ bypass from the posterior inferior cerebellar artery (PICA) to the distal AICA. The nuances of AICA aneurysms and revascularization strategies are discussed. METHODS The aneurysm and the distal segments of AICA and PICA were exposed with a retrosigmoid and far lateral approach. A side-to-side anastomosis was performed between the adjacent caudal loops of PICA and AICA. The AICA aneurysm was then treated by trapping the aneurysm-bearing segment of the parent vessel between 2 clips. RESULTS A postoperative angiogram demonstrated a patent PICA-AICA bypass and complete occlusion of the AICA aneurysm. There were no complications, and the patient made an excellent recovery. CONCLUSION The combination of parent vessel sacrifice and bypass remains an excellent option for certain difficult-to-treat aneurysms. This case involving PICA-AICA bypass to treat an AICA aneurysm serves as an example of the neurosurgeon's ability to develop unique solutions that take advantage of individual anatomy.

Treatment of aneurysms by excision or trapping with arterial reimplantation or interpositional grafting

1996 ◽  
Vol 85 (1) ◽  
pp. 178-185 ◽  
Author(s):  
Sang Youl Lee ◽  
Laligam N. Sekhar
Keyword(s):  
Superficial Temporal Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Giant Aneurysm ◽  
Temporal Artery ◽  
Left Vertebral Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Content Type ◽  
First Case ◽  
Cerebellar Artery ◽  
Fine Print

✓ The authors report three cases of ruptured, large or giant aneurysms that were treated by excision or trapping, followed by revascularization of distal vessels by means of arterial reimplantation or superficial temporal artery interpositional grafting. In the first case, a large serpentine aneurysm arising from the anterior temporal branch of the right middle cerebral artery (MCA) was excised and the distal segment of the anterior temporal artery was reimplanted into one of the branches of the MCA. In the second case, a giant aneurysm, fusiform in shape, arose from the rolandic branch of the MCA. This aneurysm was totally excised and the M3 branch in which it had been contained was reconstructed with an arterial interpositional graft. In the third case the patient, who presented with a subarachnoid hemorrhage, had a dissecting aneurysm that involved the distal portion of the left vertebral artery. In this case the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm and coursed onward to supply the brainstem. This aneurysm was managed by trapping and the PICA was reimplanted into the ipsilateral large anterior inferior cerebellar artery. None of the patients suffered a postoperative stroke and all recovered to a good or excellent postoperative condition. These techniques allowed complete isolation of the aneurysm from the normal blood circulation and preserved the blood flow through the distal vessel that came out of the aneurysm. These techniques should be considered as alternatives when traditional means of cerebral revascularization are not feasible.

scholarly journals Anterior Inferior Cerebellar Aneurysm Treated by Aneurysm Resection and Intracranial Artery Anastomosis in situ: A Case Report and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Chaojue Huang ◽  
Shixing Qin ◽  
Wei Huang ◽  
Yongjia Yu
Keyword(s):  
Surgical Treatment ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Anterior Inferior Cerebellar Artery ◽  
Intracranial Artery ◽  
Disturbance Of Consciousness ◽  
Cerebellar Artery ◽  
Wide Range ◽  
Aneurysm Resection

Background: Anterior inferior cerebellar artery (AICA) aneurysms are relatively rare in clinical practice, accounting for &lt;1% of all intracranial arteries. After the diagnosis and location are confirmed by angiography, magnetic resonance, and other imaging examinations, interventional, or surgical treatment is often used, but some complex aneurysms require reconstructive surgery.Case Description: An 8-year-old male child was admitted to the hospital due to sudden disturbance of consciousness for 2 weeks. The head CT showed hematocele in the ventricular system with subarachnoid hemorrhage in the basilar cistern and annular cistern. On admission, he was conscious, answered correctly, had a soft neck, limb muscle strength was normal, and had no cranial nerves or nervous system abnormalities. A preoperative examination showed the right side of the anterior distal arteries class under the circular wide neck aneurysm, the distal anterior inferior cerebellar artery supplying a wide range of blood to the cerebellum, the ipsilateral posterior inferior cerebellar artery absent, and the aneurysm close to the VII, VIII nerves. The aneurysm was successfully treated by aneurysm resection and intracranial artery anastomosis in situ of a2 AICA-a2 AICA.Conclusions: AICA aneurysms are relatively rare; in this case, a complex wide-necked aneurysm was successfully treated by aneurysm resection and anastomosis in situ of a2 AICA-a2 AICA. This case can provide a reference for the surgical treatment of complex anterior cerebellar aneurysms.

scholarly journals Coronavirus Disease (COVID-19) Pandemic: An Overview of Systematic Reviews

2020 ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Dónal P. O’Mathúna ◽  
Thilo Caspar von Groote ◽  
Hebatullah Mohamed Abdulazeem ◽  
Ishanka Weerasekara ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Troponin I ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Severe Disease ◽  
Ground Glass Opacity ◽  
Open Science ◽  
Frequent Pattern ◽  
Cochrane Library ◽  
The Impact

AbstractBackgroundNavigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging and ongoing critical appraisal of this output is essential. We aimed to collate and summarize all published systematic reviews on the coronavirus disease (COVID-19).MethodsNine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS and Epistemonikos) were searched from December 1, 2019 to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory and radiological findings) and quality assessment (AMSTAR 2). Meta-analysis on prevalence of clinical outcomes was performed.ResultsEighteen systematic reviews were included; one was empty. Using AMSTAR 2, confidence in the results of 13 reviews was rated as “critically low”, one as “low”, one as “moderate” and two as “high”. Symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8– 12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein (associated with lymphocytopenia) and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. Chest imaging described a frequent pattern of uni- or bilateral multilobar ground-glass opacity. Only one review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3% to 14%.ConclusionsConfidence in the results of most reviews was “critically low”. Future studies and systematic reviews should adhere to established methodologies. The majority of included systematic reviews were hampered by imprecise search strategy and no previous protocol submission.Protocol registrationThis is an extension of a PROSPERO protocol (CRD42020170623); protocol available on Open Science Framework (https://osf.io/6xtyw).

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