scholarly journals Trigeminal rhizotomies in the treatment of trigemium neuralgia

2021 ◽  
Author(s):  
Bernardo Przysiezny ◽  
Leandro José Haas ◽  
Guilherme Voltolini Staedele ◽  
Carlos Henrique Dummer ◽  
Matheus Durieux Soares ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Trigeminal Neuralgia ◽  
Arterial Hypertension ◽  
Santa Catarina ◽  
Percutaneous Approach ◽  
Therapeutic Experience ◽  
Systemic Arterial Hypertension ◽  
Reference Service ◽  
Balloon Technique

Background: Rhizotomy is a procedure that seeks to interrupt, the pain function of sensitive nerves. Trigeminal Neuralgia (TN) is a disease that can benefit from a trigeminal rhizotomy. Currently, percutaneous trigeminal radiofrequency rhizotomy and balloon microcompression techniques are widely used. Objective: To expose therapeutic experience of TN by trigeminal rhizotomy therapy. Methods: Retrospective study of TN patients undergoing trigeminal rhizotomy in a reference service in endovascular neurosurgery in Blumenau, Santa Catarina, from 2009 to 2019. The variables analyzed were gender, age, symptoms, comorbidities and procedural characteristics. Results: 39 patients were analyzed, 24 were women (61.5%) aged between 33 and 84 years and a mean of 62.8 years old. Regarding the symptoms presented, the most prevalent was headache (69.2%), followed by paresthesia (10.2%), tinnitus (7.7%) and dizziness (5.1%). For comorbidities, 25.6% had systemic arterial hypertension and 15.4% had dyslipidemia. The trigeminal branches most involved in rhizotomies were V2-V3 (56.4%), followed by V2 (28.2%), V1 (7.7%), V1-V2 (5.1%) and V3 (2.5%). The left side was more affected (56.4%). The percutaneous approach was performed in all patients, in 92.3% the balloon technique was performed and in 7.7% radiofrequency was used. In 79,5% of the cases, it was possible to accomplish the treatment with only one session. Conclusion: The approach of TN through rhizotomy proved to be a technique with low morbidity, reaffirming the good results of therapy. The monitoring of cases is essential to allow a better assessment of the long-term effectivenes of the treatment.

Drug therapy and nutritional management of metabolic syndrome associated with hyperadrenocorticism in a dog – case report

2017 ◽  
Vol XXII (131) ◽  
pp. 38-46
Author(s):  
Viviani De Marco ◽  
Elidia Zotelli dos Santos
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Systemic Arterial Hypertension ◽  
The Metabolic Syndrome ◽  
Generic Term ◽  
High Concentrations ◽  
Stable Control ◽  
Biochemical Abnormalities

Hyperadrenocorticism (HAC) is a generic term that refers to clinical and biochemical abnormalities resulting from persistently high concentrations of glucocorticoids in the bloodstream, which may occur spontaneously or iatrogenically. Chronic hypercortisolism may promote abdominal obesity, dyslipidemia, systemic arterial hypertension and insulin resistance, abnormalities associated with the metabolic syndrome (MS). The present study aims to report the presence of MS in a dog with spontaneous HAC, and its satisfactory long-term therapeutic resolution. The animal presented marked alterations in addition to the classic symptoms of HAC: discrete hyperglycemia, insulin resistance, hyperlipidemia, arterial hypertension and obesity. Complete resolution of MS and stable control of HAC were observed after five months of treatment.

Neurovascular Compression Associated with Trigeminal Neuralgia and Systemic Arterial Hypertension: Surgical Treatment

2002 ◽  
Vol 79 (3-4) ◽  
pp. 284-290 ◽  
Author(s):  
Mauricio Sendeski ◽  
Paulo Henrique Aguiar ◽  
Marcus Vinicius Zanetti ◽  
Manoel Jacobsen Teixeira ◽  
Valter Ângelo Cescato
Keyword(s):  
Surgical Treatment ◽  
Trigeminal Neuralgia ◽  
Arterial Hypertension ◽  
Neurovascular Compression ◽  
Systemic Arterial Hypertension

scholarly journals Interactive between headache, systemic arterial hypertension and stoke: a integrative review

2018 ◽  
pp. 199-204
Author(s):  
Gizele da Silva Lima ◽  
Iris Milleyde da Silva Laurentino ◽  
Vânia Nazaré da Costa Silva ◽  
Antonio Flaudiano Bem Leite ◽  
Marcelo Moraes Valença ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Secondary Outcome ◽  
Bibliographic Databases ◽  
Latin Literature ◽  
Scientific Publications ◽  
The Public ◽  
Systemic Arterial Hypertension ◽  
Methodological Procedures ◽  
Positive Results

Introduction: Several studies present evidence that headache is a symptom often associated with systemic arterial hypertension (SAH) and it may contribute to a greater potential for the development of these diseases, including the risks of more serious damages, such as stroke). Objective: To identify in the existing scientific publications the relation between migraine, systemic arterial hypertension and secondary outcome of cerebrovascular accident. Methodological procedures: This is an integrative literature review from 2014 to 2018, in the bibliographic databases of Latin Literature (LILACS) and the Medical Literature Analysis and Retrieval System Online (MEDLINE /PUBMED) conducted in April 2019. From 50 identified records, considering the selected descriptors, through selection and eligibility procedures according to the proposed inclusion and exclusion criteria, 04 articles were selected. The PRISMA tool (Preferred Reporting Items for Systematic Reviews and Meta-analyzes) was used as a guideline in the writing of the integrated review. Results: 50% of the analyzed studies directed the objectives for the investigation of the association between migraine and cardiovascular disease. The others, prioritized as objective the evaluation of migraine as a risk factor for stroke. The findings of the studies analyzed in full confirm the presence of the association of migraine with systemic arterial hypertension and stroke. Of these, only one presented no significance in the statistical model, when migraine was generally included for the risk of stroke, but when migraine with aura was inserted, it showed positive results. Conclusion: Migraine is directly associated with cardiovascular diseases and can have a significant impact, both for the patients' disability and for the public health policy, which needs to improve strategies for monitoring and preventing negative outcomes in the long term.

Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study

2020 ◽  
Vol 132 (5) ◽  
pp. 1405-1413 ◽  
Author(s):  
Michael D. Staudt ◽  
Holger Joswig ◽  
Gwynedd E. Pickett ◽  
Keith W. MacDougall ◽  
Andrew G. Parrent
Keyword(s):  
Multiple Sclerosis ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Retrospective Chart Review ◽  
Medication Usage ◽  
Free Response ◽  
Free Survival ◽  
Time To Recurrence ◽  
Significant Difference

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.

Temporal disconnection between pain relief and trigeminal nerve microstructural changes after Gamma Knife radiosurgery for trigeminal neuralgia

2020 ◽  
Vol 133 (3) ◽  
pp. 727-735
Author(s):  
Peter Shih-Ping Hung ◽  
Sarasa Tohyama ◽  
Jia Y. Zhang ◽  
Mojgan Hodaie
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Pain Intensity ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Diffusion Tensor ◽  
Gamma Knife Radiosurgery ◽  
Time Points ◽  
Microstructural Effect

OBJECTIVEGamma Knife radiosurgery (GKRS) is a noninvasive surgical treatment option for patients with medically refractive classic trigeminal neuralgia (TN). The long-term microstructural consequences of radiosurgery and their association with pain relief remain unclear. To better understand this topic, the authors used diffusion tensor imaging (DTI) to characterize the effects of GKRS on trigeminal nerve microstructure over multiple posttreatment time points.METHODSNinety-two sets of 3-T anatomical and diffusion-weighted MR images from 55 patients with TN treated by GKRS were divided within 6-, 12-, and 24-month posttreatment time points into responder and nonresponder subgroups (≥ 75% and < 75% reduction in posttreatment pain intensity, respectively). Within each subgroup, posttreatment pain intensity was then assessed against pretreatment levels and followed by DTI metric analyses, contrasting treated and contralateral control nerves to identify specific biomarkers of successful pain relief.RESULTSGKRS resulted in successful pain relief that was accompanied by asynchronous reductions in fractional anisotropy (FA), which maximized 24 months after treatment. While GKRS responders demonstrated significantly reduced FA within the radiosurgery target 12 and 24 months posttreatment (p < 0.05 and p < 0.01, respectively), nonresponders had statistically indistinguishable DTI metrics between nerve types at each time point.CONCLUSIONSUltimately, this study serves as the first step toward an improved understanding of the long-term microstructural effect of radiosurgery on TN. Given that FA reductions remained specific to responders and were absent in nonresponders up to 24 months posttreatment, FA changes have the potential of serving as temporally consistent biomarkers of optimal pain relief following radiosurgical treatment for classic TN.

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