Trigeminal neuralgia secondary to asymmetry of the petrous bone

1970 ◽  
Vol 33 (5) ◽  
pp. 596-598 ◽  
Author(s):  
Sixto Obrador ◽  
Victor G. Queimadelos ◽  
Manuel Soto
Keyword(s):  
Trigeminal Neuralgia ◽  
Petrous Bone ◽  
Therapeutic Result ◽  
Basilar Impression ◽  
Content Type ◽  
History Of ◽  
Trigeminal Root ◽  
Extradural Approach ◽  
The Right ◽  
Fine Print

✓ This patient with a 12-year history of right trigeminal neuralgia had a marked asymmetry of the skull and petrous bone due to unilateral basilar impression of the right side. Partial section of the trigeminal root through a right subtemporal extradural approach was performed, with a good therapeutic result. Stretching and angulation of the root over the ridge of the elevated petrous bone was the probable cause of the trigeminal pain.

Targeting the cranial nerve: microradiosurgery for trigeminal neuralgia with CISS and 3D-Flash MR imaging sequences

2005 ◽  
Vol 102 ◽  
pp. 107-110 ◽  
Author(s):  
Vasilios A. Zerris ◽  
Georg C. Noren ◽  
William A. Shucart ◽  
Jeff Rogg ◽  
Gerhard M. Friehs
Keyword(s):  
Mr Imaging ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Cranial Nerve ◽  
Fusion Imaging ◽  
Vascular Compression ◽  
Content Type ◽  
History Of ◽  
Fine Print

Object.The authors undertook a study to identify magnetic resonance (MR) imaging techniques that can be used reliably during gamma knife surgery (GKS) to identify the trigeminal nerve, surrounding vasculature, and areas of compression.Methods.Preoperative visualization of the trigeminal nerve and surrounding vasculature as well as targeting the area of vascular compression may increase the effectiveness of GKS for trigeminal neuralgia. During the past years our gamma knife centers have researched different MR imaging sequences with regard to their ability to visualize cranial nerves and vascular structures. Constructive interference in steady-state (CISS) fusion imaging with three-dimensional gradient echo sequences (3D-Flash) was found to be of greatest value in the authors' 25 most recent patients.In 24 (96%) out of the 25 patients, the fifth cranial nerve, surrounding vessels, and areas of compression could be reliably identified using CISS/3D-Flash. The MR images were acceptable despite patients' history of microvascular decompression, radiofrequency (RF) ablation, or concomitant disease. In one of 25 patients with a history of multiple RF lesions, the visualization was inadequate due to severe trigeminal nerve atrophy.Conclusions.The CISS/3D-Flash fusion imaging has become the preferred imaging method at the authors' institutions during GKS for trigeminal neuralgia. It affords the best visualization of the trigeminal nerve, surrounding vasculature, and the precise location of vascular compression.

Brain and bone scans in primary Ewing's sarcoma of the petrous bone

1976 ◽  
Vol 44 (5) ◽  
pp. 608-612 ◽  
Author(s):  
Pete M. Fitzer ◽  
William R. Steffey
Keyword(s):  
Bone Scan ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Petrous Bone ◽  
Diagnosis And Treatment ◽  
Content Type ◽  
Brain Scan ◽  
Bone Scans ◽  
The Right ◽  
Fine Print

✓ The authors present a case in which primary Ewing's sarcoma of the right petrous pyramid in a 9-year-old girl showed no uptake on a 99mTc-pertechnetate nuclide angiogram. Intense uptake was present on a 99mTc-polyphosphate bone scan, but a static brain scan was only minimally abnormal. The diagnosis and treatment of Ewing's sarcoma are reviewed.

Cerebral mycotic aneurysm of fungal origin

1978 ◽  
Vol 49 (1) ◽  
pp. 0107-0110 ◽  
Author(s):  
Gulshan K. Ahuja ◽  
Neeraj Jain ◽  
Malini Vijayaraghavan ◽  
Subimal Roy
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mycotic Aneurysm ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Content Type ◽  
History Of ◽  
The Right ◽  
Internal Carotid Arteries ◽  
Fine Print

✓ A young man who had a long history of sinusitis developed subarachnoid hemorrhage and died. Autopsy showed a mycotic aneurysm of fungal origin at the junction of the right posterior cerebral and internal carotid arteries. Four of five reported cases of fungal aneurysm were due to Aspergillus infection.

Decompression of the posterior trigeminal root in trigeminal neuralgia

1982 ◽  
Vol 57 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Palle Taarnhøj
Keyword(s):  
Trigeminal Neuralgia ◽  
Content Type ◽  
Long Term Follow Up ◽  
Trigeminal Root ◽  
Suboccipital Approach ◽  
Fine Print

✓ The author presents a long-term follow-up report of his experience with decompression of the posterior trigeminal root in 350 cases. He has found that the suboccipital approach results in fewer recurrences of pain than the temporal approach.

Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery

2002 ◽  
Vol 96 (3) ◽  
pp. 532-543 ◽  
Author(s):  
Marshall Devor ◽  
Ruth Govrin-Lippmann ◽  
Z. Harry Rappaport
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Negative Symptoms ◽  
Ultrastructural Level ◽  
Nerve Fibers ◽  
Decompression Surgery ◽  
Content Type ◽  
Trigeminal Root ◽  
Microvascular Decompression Surgery ◽  
Fine Print

Object. Recent progress in the understanding of abnormal electrical behavior in injured sensory neurons motivated an examination, at the ultrastructural level, of trigeminal roots of patients with trigeminal neuralgia (TN). Methods. In 12 patients biopsy specimens of trigeminal root were obtained during surgery for microvascular decompression. Pathological changes in tissue included axonopathy and axonal loss, demyelination, a range of less severe myelin abnormalities (dysmyelination), residual myelin debris, and the presence of excess collagen, including condensed collagen masses in two cases. Within zones of demyelination, groups of axons were often closely apposed without an intervening glial process. Pathological characteristics of nerve fibers were clearly graded with the degrees of root compression noted at operation. Pain also occurred, however, in some patients who did not appear to have a severe compressive injury. Conclusions. Findings were consistent with the ignition hypothesis of TN. This model can be used to explain the major positive and negative symptoms of TN by axonopathy-induced changes in the electrical excitability of afferent axons in the trigeminal root and of neuronal somata in the trigeminal ganglion. The key pathophysiological changes include ectopic impulse discharge, spontaneous and triggered afterdischarge, and crossexcitation among neighboring afferents.

Choristoma of the intracranial maxillary nerve in a child

1994 ◽  
Vol 81 (5) ◽  
pp. 788-791 ◽  
Author(s):  
Gabriel Lena ◽  
Thierry Dufour ◽  
Danielle Gambarelli ◽  
Brigitte Chabrol ◽  
Josette Mancini
Keyword(s):  
Resonance Imaging ◽  
Total Removal ◽  
Total Resection ◽  
Anterior Portion ◽  
Content Type ◽  
Maxillary Nerve ◽  
History Of ◽  
Foramen Rotundum ◽  
Extradural Approach ◽  
Fine Print

This report describes what the authors believe to be the first reported case of choristoma of the intracranial maxillary nerve. This 12-year-old girl presented with a 5-year history of severe isolated left-sided trigeminal neuralgia. Computerized tomography and magnetic resonance imaging revealed a mass below the anterior portion of the left cavernous sinus, enlarging the foramen rotundum. Total resection was achieved via a pterional extradural approach. Histological examination revealed a choristoma composed of smooth-muscle fibers. The histogenesis of these tumors when they develop in a nerve remains unclear. They may represent abnormal migration or proliferation of neuroectodermal tissue in or close to a peripheral nerve. Total removal of these tumors should be attempted at initial diagnosis.

Cerebrospinal acanthamebic granulomas

2003 ◽  
Vol 99 (3) ◽  
pp. 572-574 ◽  
Author(s):  
Vernon Velho ◽  
Gopal Krishan Sharma ◽  
Deepak Amrut Palande
Keyword(s):  
Surgical Excision ◽  
Imaging Studies ◽  
Content Type ◽  
Mode Of Entry ◽  
Antituberculosis Treatment ◽  
History Of ◽  
Severe Infections ◽  
The Central Nervous System ◽  
The Right ◽  
Fine Print

✓ The authors present the case of a previously healthy 26-year-old man who presented with cerebrospinal acanthamebic granulomas, and they review the literature on acanthamebic granulomas of the central nervous system (CNS). The appearance of the lesion on imaging studies suggested the presence of tuberculous granulomas, which are common in India, and antituberculosis treatment was started. Despite surgical excision of a granuloma located in the right temporoparietal region and an intramedullary granuloma at T7–8, the disease progressed and resulted in death. Unlike other cases, this patient was not immunocompromised, had no history of engaging in water activities, and had no ulcers on his body, leaving in question the mode of entry used by the ameba. Acanthamebic granulomas can cause severe infections in healthy patients as well as in sick ones. This disease should be considered in the differential diagnosis when treating infective granulomas of the CNS.

Symptomatic cerebral histoplasmoma

1980 ◽  
Vol 52 (2) ◽  
pp. 273-275 ◽  
Author(s):  
Sydney S. Schochet ◽  
Mohammad Sarwar ◽  
Patrick J. Kelly ◽  
Brent E. Masel
Keyword(s):  
Differential Diagnosis ◽  
Parietal Lobe ◽  
Past History ◽  
Content Type ◽  
Pathological Evaluation ◽  
Peripheral Ring ◽  
History Of ◽  
The Right ◽  
Tomography Scan ◽  
Fine Print

✓ A 53-year-old man, with a past history of a thoracotomy 7 years previously, developed seizures. A computerized tomography scan with contrast medium revealed a peripheral ring-like lesion in the anterolateral part of the right parietal lobe. Pathological evaluation of the resected lesion demonstrated it to be a histoplasmoma. Although rare, a histoplasmoma should be included in the differential diagnosis of a ring-shaped lesion in a patient with previous pulmonary disease.

A 10-year experience in the treatment of trigeminal neuralgia

1982 ◽  
Vol 57 (6) ◽  
pp. 757-764 ◽  
Author(s):  
Harry van Loveren ◽  
John M. Tew ◽  
Jeffrey T. Keller ◽  
Mary A. Nurre
Keyword(s):  
Trigeminal Neuralgia ◽  
Neurovascular Compression ◽  
Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Significant Difference ◽  
Technical Advances ◽  
Trigeminal Root ◽  
Fine Print

✓ Of 1000 patients with classic trigeminal neuralgia who were treated during the last 10 years, 90% had an initial favorable response to medical therapy, but 75% (750 patients) failed to achieve satisfactory long-term relief. Of these, 700 patients were treated by percutaneous stereotaxic rhizotomy (PSR) and 50 were selected for posterior fossa exploration (PFE). Of the 50 patients undergoing PFE, 82% had neurovascular contact at the trigeminal root entry zone, but only 46% were judged to have had significant neurovascular compression. Exploration was negative in 16% of patients and revealed neural compression by bone in 2%. Patients with neurovascular compression were treated by microvascular decompression (MVD); all other patients with exploratory surgery underwent partial sensory rhizotomy. At 3 years after PFE, 84% of patients are pain-free. Results are excellent in 68%, good in 12%, fair in 4%; 12% had a recurrence of their neuralgia. The 700 patients treated by PSR have been followed for 6 years. Results are excellent in 61%, good in 13%, fair in 5%, and poor in 1%; 20% had a recurrence. This study indicates that there is no significant difference in results between PSR and PFE in the treatment of trigeminal neuralgia. The concept that neurovascular compression is a mechanical factor in the etiology of trigeminal neuralgia was supported, but neurovascular compression was less common than previously reported. Percutaneous stereotaxic rhizotomy is a less formidable procedure than PFE, and is easily repeated. Recent technical advances have improved the results obtained with PSR. Therefore, PSR remains the procedure of choice for the majority of patients with trigeminal neuralgia.

Tapia's syndrome caused by a neurofibroma of the hypoglossal and vagus nerves

1980 ◽  
Vol 52 (5) ◽  
pp. 730-732 ◽  
Author(s):  
Giancarlo Andrioli ◽  
Luca Rigobello ◽  
Salvatore Mingrino ◽  
Vito Toso
Keyword(s):  
Vocal Cord ◽  
Cranial Nerves ◽  
Complete Removal ◽  
Nodose Ganglion ◽  
Vagus Nerves ◽  
Content Type ◽  
Tapia’S Syndrome ◽  
History Of ◽  
The Right ◽  
Fine Print

✓ Tapia's syndrome is characterized by unilateral paralysis of the tongue and vocal cord, and is caused by a lesion of the 10th and 12th cranial nerves below the nodose ganglion, without involvement of the pharyngeal branches of the 10th nerve. The authors report the case of a 25-year-old man who presented with a 4-year history of progressive glossolaryngeal paralysis. Operation through the right laterocervical region allowed complete removal of a neurofibroma involving the 10th and 12th nerves at their crossing below the nodose ganglion.

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