Electrical neurocoagulation may be effective for intractable trigeminal neuralgia caused by vertebrobasilar dolichoectasia

Ishii, Akira; Kubota, Yuichi; Okamoto, Saori; Matsuoka, Go; Yato, Seiji; Hori, Tomokatsu; Okada, Yoshikazu

doi:10.1007/s10143-013-0454-1

Cited by 8 publications

(3 citation statements)

References 20 publications

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“…RFTC can be used in bilateral pathology,[ 130 ] elderly,[ 130 ] recurrence after failed MVD,[ 82 ] vertebrobasilar dolichoectasia,[ 131 ] and MS. Peripheral nerve block,[ 132 ] and general anesthesia could relieve perioperative pain without an increase in complications.…”

Section: Radiofrequency Thermocoagulationmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.

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Section: Radiofrequency Thermocoagulationmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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“…This leaves the field open for innovative surgical techniques to provide superior outcomes to these known interventions. Electrical neurocoagulation, cutting of the tentorium, endovascular stenting, and scarring of the dura to reposition the basilar artery are techniques that are being explored as alternative treatments to MVD and GKRS [18][19][20][21]. Some claim to even have fewer complications, better long-term outcomes, and require less procedure technicality.…”

Section: Discussionmentioning

confidence: 99%

A Case With Twists and Turns: A Report of Vertebrobasilar Dolichoectasia

Thomas,

Campbell

2024

Cureus

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Vertebrobasilar dolichoectasia (VBD) is a rare anatomical abnormality of the vertebral artery system, defined as irregular expansion, elongation, and tortuosity of vertebral arteries. Anomalies of the vertebrobasilar artery can have a wide variety of clinical presentations, ranging from simple headaches to debilitating strokes. We present the case of an atypical presentation of VBD which mimicked trigeminal neuralgia by compressing the trigeminal nerve. There are currently no guidelines concerning the management of VBD, nor is there evidence of a definitive cure. This case invoked discussions among the medical team as to whether management should be medically or surgically focused, as well as long-term outcomes for patients with VBD. The superiority of medical versus surgical treatment of this issue is still a debated topic. This patient trialed medical management with dexamethasone and carbamazepine with no improvement in symptoms. He then underwent surgical gamma knife treatment but even this invasive measure was unsuccessful at relieving his symptoms. We hope that by presenting this case, we can display how the therapies available for VBD are limited and often unsuccessful in relieving the disease burden in patients with VBD.

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“…Cases of trigeminal neuralgia secondary to compression by a dolichoectatic vertebrobasilar artery[4,5,[6][7][8][9][10][11][12][13][14][15][16][17][18][19] …”

mentioning

confidence: 99%