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Neurovascular compression

Over the course of decades, Neurovascular compression (NVC) has become established as the cause of nearly all cases of classic or typical TN, HFS, and glossopharyngeal neuralgia (GPN) when strict diagnostic criteria are applied. These conditions are also amenable to high rates of cure by the atraumatic alleviation of culprit vascular compression via Jannetta’s MVD procedure. However, the NVC theory has also been invoked by some as a potential cause of other conditions such as non-episodic facial pain (e.g., type 2 TN), Bell’s palsy, tinnitus, vertigo, hypertension, and diabetes.

see also Hemilaryngopharyngeal spasm.

Evidence of an association between these conditions and culprit vascular compression is less robust, and MVD surgery has not been generally accepted as effective in their treatment. There remains an appropriately great burden of proof when proposing an NVC etiology, just as Jannetta faced 1).

The symptoms of trigeminal neuralgia are believed to arise from neurovascular compression near the trigeminal root entry zone of the trigeminal nerve; however, this still remains theory 2) 3).

A case of posterior cerebral artery aneurysm, which caused the isolated trigeminal neuralgia in a 48-year-old woman, was operated on through microvascular decompression and the aneurysm was wrapped 4).

Kaufmann AM. Editorial. Considering a neurovascular compression etiology. J Neurosurg. 2018 Jul 20:1-3. doi: 10.3171/2018.3.JNS18385. [Epub ahead of print] PubMed PMID: 30028265.
Leal PRL, Hermier M, Froment JC, Souza MA, Cristino-Filho G, Sindou M. Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Acta Neurochir (Wien). 2010;152(5):817–825.
Thomas KL, Vilensky JA. The anatomy of vascular compression in trigeminal neuralgia. Clin Anat. 2013. doi: 10.1002/ca.22157.
Dzierżanowski J, Słoniewski P. Trigeminal neuralgia caused by aneurysm of the posterior cerebral artery: a case description and the analysis of anatomical variety of vascular complex in the rood entry zone of trigeminal nerve. Folia Morphol (Warsz). 2014;73(2):224-228. doi: 10.5603/FM.2014.0033. PubMed PMID: 24902103.
neurovascular_compression.txt · Last modified: 2018/07/22 16:28 by administrador