The thematic review discusses various points of view on the topographic and atomic features of the location of the root of the trigeminal nerve and the superior cerebellar artery that serve as the foundation for the development of classical trigeminal neuralgia. The diagnostic capabilities of magnetic resonance imaging in the recognition of neurovascular conflict as the pathogenetic basis of the disease are considered. The search for diagnostic criteria that distinguish neurovascular conflict from neurovascular contact by improving both the performance of MRI and the new technical possibilities of its interpretation is highlighted in the chronological aspect. The possibilities of multispiral X-ray computed angiography in 3D mode as an alternative method for diagnosing neurovascular conflict are described.
Objective: to study the formation of neurovascular conflicts of two types in patients with classical trigeminal neuralgia, depending on the influence of the environment of the Rostov region.Materials and methods: a retrospective study of the features of neurovascular conflict was conducted in 175 patients from the Rostov region who suffered from classical trigeminal neuralgia. The diagnosis of a variant of neurovascular conflict was carried out using spiral computed tomography on the device «Philips Ingenuity Core 128» The variant of neurovascular conflict was verified intraoperatively, when performing microvascular decompression of the trigeminal nerve root.Results: neurovascular conflict, both of the first and second types, occurs twice as often in women as in men. The development of the adhesive process in the zone of neurovascular conflict, which brings the root even closer to the artery that injures it, is due to the duration of the pathological process, during which inflammatory diseases of the paranasal sinuses, carious teeth, persistent herpesvirus infection play a significant role.Conclusions: variants of the syntopia of the trigeminal nerve root with the superior cerebellar artery in neurovascular conflict do not depend on environmental factors, and the frequency of occurrence of one type or another, as well as the gender ratio, correspond to the population.
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