Correlations between the trigeminal nerve microstructural changes and the trigeminal-pontine angle features

Pang, Huize; Sun, Hao; Fan, Guoguang

doi:10.1007/s00701-019-04099-6

Cited by 15 publications

(9 citation statements)

References 28 publications

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“…Moreover, the apparent diffusion coefficient (ADC) on the affected side was significantly lower than that on the unaffected side or in the control group (Leal et al, 2019 ). These observations accord with the study by Pang et al ( 2019 ). The postoperative findings showed that MVD did not change the differences in FA, but the ADC normalized in the affected nerves after MVD (Leal et al, 2019 ).…”

Section: Factors Associated With the Changes In The Nerve Structuresupporting

confidence: 94%

“…Not only a small CPA but also a sharp nerve-pontine angle can lead to the NVC and also to the exacerbation of nerve degeneration (Pang et al, 2019 ; Zhu et al, 2020 ). From the clinical point of view, these anatomical factors are insufficient to cause NVC-related symptoms by themselves.…”

Section: The Influence Of Anatomical and Hemodynamical Changes On The...mentioning

confidence: 99%

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The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review

Szmyd

Sołek

Błaszczyk

et al. 2022

Front. Mol. Neurosci.

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Neurovascular compression syndromes (NVC) are challenging disorders resulting from the compression of cranial nerves at the root entry/exit zone. Clinically, we can distinguish the following NVC conditions: trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. Also, rare cases of geniculate neuralgia and superior laryngeal neuralgia are reported. Other syndromes, e.g., disabling positional vertigo, arterial hypertension in the course of NVC at the CN IX-X REZ and torticollis, have insufficient clinical evidence for microvascular decompression. The exact pathomechanism leading to characteristic NVC-related symptoms remains unclear. Proposed etiologies have limited explanatory scope. Therefore, we have examined the underlying pathomechanisms stated in the medical literature. To achieve our goal, we systematically reviewed original English language papers available in Pubmed and Web of Science databases before 2 October 2021. We obtained 1694 papers after eliminating duplicates. Only 357 original papers potentially pertaining to the pathogenesis of NVC were enrolled in full-text assessment for eligibility. Of these, 63 were included in the final analysis. The systematic review suggests that the anatomical and/or hemodynamical changes described are insufficient to account for NVC-related symptoms by themselves. They must coexist with additional changes such as factors associated with the affected nerve (e.g., demyelination, REZ modeling, vasculature pathology), nucleus hyperexcitability, white and/or gray matter changes in the brain, or disturbances in ion channels. Moreover, the effects of inflammatory background, altered proteome, and biochemical parameters on symptomatic NVC cannot be ignored. Further studies are needed to gain better insight into NVC pathophysiology.

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Section: Factors Associated With the Changes In The Nerve Structuresupporting

confidence: 94%

Section: The Influence Of Anatomical and Hemodynamical Changes On The...mentioning

confidence: 99%

The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review

Szmyd

Sołek

Błaszczyk

et al. 2022

Front. Mol. Neurosci.

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show abstract

“…Most recently, Fukuoka et al found that a more flat PCF might be associated with poor outcome of MVD for TNs (9). As reported by literatures, other anatomic features were also correlated with outcomes of MVD for TNs (30)(31)(32). Therefore, PCF morphometric features might influence the outcome of MVD.…”

Section: Discussionmentioning

confidence: 86%

Comparative Analysis of Trigeminal Neuralgia Caused by Sole Arterial and Venous Compression: Clinical Features and Surgical Outcomes From 222 Cases

et al. 2021

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Background: Compared with trigeminal neuralgia (TN) caused by arterial neurovascular conflict (NVC), the clinical characteristics and managements for TN with venous NVC are not well-established. This study aims to comparatively summarize the clinical features and surgical outcomes of microvascular decompression (MVD) for patients with TN caused by sole arterial and venous compression, with a particular focus on the morphological features of posterior cranial fossa (PCF).Methods: A total of 222 patients with TN caused by sole arterial NVC (188/84.7%) and venous NVC (34/15.3%) underwent MVD in our department from January 2014 to December 2018. The patient data were analyzed retrospectively. Particularly, we focused on the potential impact of PCF on surgical outcomes.Results: Compared with arterial NVC, V3 branch of the trigeminal nerve was more frequently involved in venous NVC (p = 0.009). The most common compression site was root entry zone for arterial NVC (68.6%) and midcisternal segment for venous NVC (76.5%) (p < 0.001). No serious post-operative complication was observed in the two groups. Both short- and long-term outcomes were relatively worse in venous NVC cases compared with arterial NVC cases (p = 0.001 and p = 0.030, respectively); and a dominantly higher rate of delayed cure was demonstrated in venous NVC cases (p < 0.001). TN patients with venous NVC revealed a more flat-shaped PCF than those with arterial NVC. Moreover, flat-shaped PCF morphometry was negatively correlated with surgical outcomes of TN patients with arterial NVC, but not with those of venous NVC cases.Conclusions: MVD is an effective and safe treatment for patients with TN caused by either arterial or venous NVC. Patients with a more flat-shaped PCF might be vulnerable to venous compression. Our study demonstrated that PCF morphometry only affected the surgical outcomes of patients with TN caused by arterial NVC, but not the outcomes of those with venous NVC.

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“…Cross-sectional measurement of the cisternal area and cisternal length of the trigeminal nerve was performed according to Park et al and Pang et. al [ 14 , 15 ]. A mean value was calculated.…”

Section: Anatomical Features Obtained Intraoperativelymentioning

confidence: 99%

Purely venous compression in trigeminal neuralgia—can we predict the outcome of surgery

et al. 2022

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Purpose Controversies regarding venous compression and trigeminal neuralgia (TN) still exist. The study demonstrates our experience for microvascular decompression (MVD) in TN caused by purely venous compression. The goal was to identify prognostic anatomical or surgical factors that may influence the outcome. Methods Between 2004 and 2020, 49 patients were operated with purely venous compression. Average age was 58.4 years. Mean history of TN was 7.8 years. Microsurgical procedures included transposition or separation of the vein, coagulation, and division. Several features have been analyzed with respect to BNI scores. Results Evaluation on discharge revealed a complete pain relief in 39 (80%), partial improvement in 7 (14%), and no benefit in 3 (6%) patients. Facial hypesthesia was reported by 14 (28.6%) patients. Mean follow-up (FU) was 42.1 months. BNI pain intensity score on FU revealed 71.4% excellent to very good scores (score 1: 32 (65.3%); 2: 3 (6.1%)). BNI facial numbness score 2 could be detected in 13 patients (26.5%) during FU. There was no statistical relationship between immediate pain improvement or BNI pain intensity score on FU with respect to surgical procedure, size of trigeminal cistern, type of venous compression, venous caliber, trigeminal nerve indentation, or neurovascular adherence. BNI facial numbness score was dependent on type of venous compression (p < 0.05). Conclusion We did not find typical anatomical features that could either predict or influence the outcome regarding pain improvement or resolution in any form. Neither classic microvascular decompression (interposition/transposition) nor sacrificing the offending vein made any difference in outcome.

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Correlations between the trigeminal nerve microstructural changes and the trigeminal-pontine angle features

Cited by 15 publications

References 28 publications

The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review

The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review

Comparative Analysis of Trigeminal Neuralgia Caused by Sole Arterial and Venous Compression: Clinical Features and Surgical Outcomes From 222 Cases

Purely venous compression in trigeminal neuralgia—can we predict the outcome of surgery

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