Hemodynamic features of offending vessels at neurovascular contact in patients with trigeminal neuralgia and hemifacial spasm

OBJECTIVEOffending vessels at the site of neurovascular contact (NVC) in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS) may have specific hemodynamic features. The purpose of this study was to investigate the wall shear stress (WSS) of offending vessels at NVCs by conducting a computational fluid dynamics (CFD) analysis.METHODSThe authors retrospectively analyzed the cases of 20 patients (10 with TN and 10 with HFS) evaluated by 3D CT angiography and used the imaging findings for analysis of the hemodynamic parameters. The 3D CFD images were directly compared with the NVCs determined by simulated multifusion images of CT angiogram and MR cisternogram, and operative photos. The magnitudes of the WSS (WSSm) at the proximal (WSSm-p), just-beginning (WSSm-j), contact site (WSSm-s), and distal (WSSm-d) areas of each NVC were analyzed. The ratios of the WSSm-j, WSSm-s, and WSSm-d areas to the WSSm-p area were calculated individually. The direction of the WSS (WSSv) and its temporal variation (WSSvV) were depicted and morphologically compared with the NVC confirmed by simulated images and operative findings.RESULTSThe ratios of WSSm at the just-beginning and the contact site to the proximal area of the NVCs (WSSm-j/WSSm-p and WSSm-s/WSSm-p) were both significantly higher than that at the distal area (WSSm-d/WSSm-p) (p < 0.05). The WSSv and WSSvV at the NVCs showed small variation in a single cardiac cycle, especially along the areas that were in contact with the affected nerve.CONCLUSIONSAreas of relatively high WSSm and temporal variation of WSSm (WSSmV) were observed at the NVCs. Less mobility of the WSSv and WSSvV was detected along the side of the vessels in contact with the nerves. These findings may be consistent with the actual area of the NVC. Hemodynamic features of the site of NVC can be added to the preoperative simulation for MVD surgery, which may be useful for the diagnosis and treatment planning of TN and HFS.

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Trigeminal neuralgia and hemifacial spasm as false localizing signs in patients with a contralateral mass of the posterior cranial fossa

Journal of Neurosurgery ◽

10.3171/jns.1996.84.6.1067 ◽

1996 ◽

Vol 84 (6) ◽

pp. 1067-1071 ◽

Cited By ~ 26

Author(s):

Nobuki Matsuura ◽

Akinori Kondo

Keyword(s):

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Cranial Nerve ◽

Petrous Bone ◽

Posterior Cranial Fossa ◽

Vascular Involvement ◽

Arachnoid Membrane ◽

Content Type ◽

Cranial Fossa ◽

Operative Findings

✓ Trigeminal neuralgia and hemifacial spasm were false localizing signs in three patients with contralateral space-occupying mass lesions in the posterior cranial fossa. According to radiological observations, the brainstem was remarkably displaced and distorted toward the side contralateral to the mass in all three cases. In the two cases with trigeminal neuralgia, the fifth cranial nerve was embedded in a thick arachnoid membrane and strongly compressed and angulated between the brainstem and the petrous bone, but there was no apparent vascular involvement. In the case with hemifacial spasm, only the contralateral tumor was removed. Postoperatively, all three patients experienced complete cessation of the symptoms without recurrence. Based on the operative findings, the authors postulate that angulation and distortion of the axis of the cranial nerve due to the contralateral mass, accompanied by thickening of the arachnoid membrane around the nerve, play an important role in false localizing signs, particularly in patients with trigeminal neuralgia.

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Trigeminal neuralgia plus hemifacial spasm caused by a dilated artery: a case of painful tic convulsif syndrome

The Lancet ◽

10.1016/s0140-6736(19)32598-x ◽

2019 ◽

Vol 394 (10211) ◽

pp. e36 ◽

Cited By ~ 1

Author(s):

Gabriel Crevier-Sorbo ◽

Andrea Brock ◽

John D Rolston

Keyword(s):

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Painful Tic Convulsif

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Neuroendoscopy in microvascular decompression for trigeminal neuralgia and hemifacial spasm: Technical note

Neurological Research ◽

10.1080/01616412.2000.11740712 ◽

2000 ◽

Vol 22 (5) ◽

pp. 522-526 ◽

Cited By ~ 24

Author(s):

K. Abdeen ◽

Y. Kato ◽

N. Kiya ◽

K. Yoshida ◽

T. Kanno

Keyword(s):

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Microvascular Decompression ◽

Technical Note

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LIVE RENAL DONORS

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2352 ◽

2010 ◽

Vol 17 (02) ◽

pp. 241-245

Author(s):

HAFIZ SHAHZAD ASHRAF ◽

Shafique Ahmed ◽

IMRAN HYDER ◽

Mubashir Ijaz ◽

MOHAMMAD USMAN KHAN

Keyword(s):

Ct Angiography ◽

Kidney Diseases ◽

Imaging Modality ◽

Helical Computed Tomography ◽

Medical Institute ◽

Renal Vasculature ◽

Conventional Angiography ◽

Ct Angiogram ◽

Operative Findings ◽

Collecting System

Objectives: To compare the findings of helical computed tomographic angiography and intra-operative findings in live related donors. To evaluate the accuracy of helical computed tomography with advanced 3D techniques in depicting the renal vasculature, parenchymal and anatomy of collecting system. Setting: Sheikh Zayed Post Graduate Medical Institute and National Institute of kidney diseases Lahore. Material and Method: Between June 2006 to May 2009 eighty potential donors underwent CT angiogram as a part of theirpreoperative workup. We retrospectively studied the CT angiogram and compared the finding with the surgical findings. The results were reviewed with radiologists to determine the discrepancy in discordant cases. Results: The accuracy of CT angiography was 93.40% to predict number of vessels. Five arteries and one vein was missed, this disconcordant comprised 7.59% during initial CT interpretation. The overallconcordance between CT angiography and operative findings in delineating the arterial anatomy was found in 74(93.67%) and venous in 78 (98.73%) donors. All CT scans demonstrated normal collecting system except one, which showed a dilated right pelvicalical system and ureter. Simple renal cysts about the size of 2-4 cm were found in the four left kidneys. CT scan supplied additional important anatomical informationincluding kidney size and the presence of nephrolithiasis. Conclusion: Helical CT angiography is very specific for arterial and venous anatomy as well as other anatomical and functional details. It provides all the information required by a surgeon. It can become the single imaging modality for preoperative assessment of potential donors in place of conventional angiography and intravenous urography. CT angiography isminimally invasive and cost effective.

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Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

10.21203/rs.3.rs-1064619/v1 ◽

2021 ◽

Author(s):

Tao Sun ◽

Wentao Wang ◽

Longshuang He ◽

Yu Su ◽

Ning Li ◽

...

Keyword(s):

Nervous System ◽

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Treatment Strategies ◽

Glossopharyngeal Neuralgia ◽

Case Presentation ◽

Involuntary Contraction ◽

History Of ◽

Primary Trigeminal Neuralgia

Abstract Background: Primary trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN) are common diseases of nervous system, with similar pathogenesis and treatment strategies. Coexistent of such disease, especially coexistent of TN-HFS-GN simultaneously, is very rare. To date, only nine cases have been reported.Case Presentation: A 70-year-old male with a history of hypertension and diabetes complained of severe involuntary contraction for about 10 years, knife-like and lighting-like pain, which was restricted to the distribution of the second and third branches of trigeminal nerve and pharynx and root of tongue, for about 2 years. Coexistent of TN HFS and GN was diagnosed and MVD was carried out. After MVD, the patient completely free from symptoms and no recurrence and hypoesthesia were recorded in 18 months follow up.Conclusion: Here we report the tenth and oldest male patient with coexistent of TN-HFS-GN. Despite limited reports, MVD is the preferred choice for such diseases which can free patients from spasm and neuralgia.

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Operative findings in cases of trigeminal neuralgia without vascular compression: proposal of a different mechanism

Journal of Clinical Neuroscience ◽

10.1054/jocn.2001.0922 ◽

2002 ◽

Vol 9 (2) ◽

pp. 200-204 ◽

Cited By ~ 51

Author(s):

Masatsune Ishikawa ◽

Shogo Nishi ◽

Tomokazu Aoki ◽

Takashi Takase ◽

Eiki Wada ◽

...

Keyword(s):

Trigeminal Neuralgia ◽

Vascular Compression ◽

Operative Findings

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TRIGEMINAL NEURALGIA—HEMIFACIAL SPASM—PAGET'S DISEASE

Brain ◽

10.1093/brain/89.3.555 ◽

1966 ◽

Vol 89 (3) ◽

pp. 555-562 ◽

Cited By ~ 43

Author(s):

W. JAMES GARDNER ◽

DONALD F. DOHN

Keyword(s):

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Paget’S Disease ◽

Paget's Disease

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Endoscopic-Assisted Microvascular Decompression

Effective Techniques for Managing Trigeminal Neuralgia - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-5349-6.ch007 ◽

2018 ◽

pp. 139-154

Author(s):

M. Yashar S. Kalani ◽

Michael R. Levitt ◽

Celene B. Mulholland ◽

Charles Teo ◽

Peter Nakaji

Keyword(s):

Trigeminal Neuralgia ◽

Minimally Invasive ◽

Effective Treatment ◽

Hemifacial Spasm ◽

Microvascular Decompression ◽

Patient Population ◽

Surgical Intervention ◽

Cranial Nerves ◽

Vascular Compression ◽

Ephaptic Transmission

Diseases of ephaptic transmission are commonly caused by vascular compression of cranial nerves. The advent of microvascular decompression has allowed for surgical intervention for this patient population. This chapter highlights the technique of endoscopic-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm. Endoscopy and keyhole techniques have resulted in a minimally invasive and effective treatment of symptoms for patients with neuralgia.

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