Flat Posterior Cranial Fossa Affects Outcomes of Microvascular Decompression for Trigeminal Neuralgia

Fukuoka, Toshiki; Nishimura, Yusuke; Hara, Masahito; Nomura, K.; Ryu, Hiroshi; Yoshikawa, Satoshi; Wakabayashi, Toshihiko

doi:10.1016/j.wneu.2017.12.114

Cited by 10 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, the volume of PCF was measured similarly in both arterial and venous compression TNs, but a more flat-shaped (short along the superior–inferior axis and longer along the left–right axis) PCF was identified in the venous NVC group in comparison with the arterial NVC group, indicating that the PCF morphometry might influence the vascular development and in turn result in a different NVC in the prevalence of TNs. Of the 188 TNs caused by arterial compression, PCF morphometry was positively associated with MVD outcomes, which was in accordance with the previous reports ( 9 ). Although TNs with venous compression displayed a more flat-shaped PCF, the outcomes of MVD for these patients were not influenced by PCF morphometry.…”

Section: Discussionsupporting

confidence: 93%

“…On the other hand, we also focused on the evaluation of PCF on the surgical outcomes of TNs, which was also absent in the previous reports. 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 – 32 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, in comparison with arterial NVC, the clinical characteristics and managements for venous NVC are not well-established. Most recently, a flat-shaped posterior cranial fossa (PCF) was identified as well as its association with the outcome of MVD for TN patients ( 9 ). However, the morphological features of PCF in different TN cases with arterial or venous NVC and its relationship with MVD outcomes have not been comparatively studied.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2021

View full text Add to dashboard Cite

show abstract

“…And width (X) was defined as the distance between the bilateral transverse-sigmoid sinus junctions along the rightleft axis (Xaxis). The morphology and volume of the PCF were evaluated by measuring absolute X, Y, and Z values, the ratio of Z to X extent (Z/X), the ratio of Z to Y extent (Z/Y), and the volume (πXYZ/6) of the ellipsoid 5) .…”

Section: Imaging Analysismentioning

confidence: 99%

“…A number of mechanisms likely underly the development of neurovascular conflict leading to HFS. The incidence of HFS is increased in the presence of hypertension (HTN) in individuals older than 50 years, women, and Asians 5) . Anatomical features that characterize patients with HFS have been reported.…”

Section: Introductionmentioning

confidence: 99%

Conformation of the Posterior Fossa of the Skull: A Predisposing Factor in Patients with Hemifacial Spasm

Kang

Choi

Lee

et al. 2020

Nerve

View full text Add to dashboard Cite

Hemifacial spasm (HFS) can be caused by vascular compression of the facial nerve at the root entry zone in the brain stem. The study aims to analyze the length and volume of the posterior cranial fossa (PCF) and the angle of skull flatness to evaluate any possible contribution of morphological characteristics to the development of neurovascular compression leading to HFS. Methods: We enrolled 30 patients with HFS and matched them by age and sex to controls. Three-dimensional volumetric analyses of the PCF were performed using magnetic resonance imaging. We measured the angle and approximate volume of the PCF using the ellipsoid method. Results: The mean volume of the PCF in patients with HFS was significantly lower (220.2±24.9 vs. 243.1±31.2; p=0.003) than in controls. In addition, the mean angle of the PCF of patients with HFS was smaller than that of controls (100.7±6.0 vs. 106.5±7.0; p=0.001). Several clinical factors were investigated, and there were significant associations between PCF volume and hypertension. Hypertension is more common in the HFS patient group than in the control group (18/30 [60.0%] vs. 10/30 [33.3 %]; p=0.038). Conclusion: Our results suggest that patients with HFS can be characterized by flatness of the skull and small volume of the PCF. These structural differences may play a role in neurovascular compression in patients with HFS.

show abstract

Atlantoaxial posterior screw fixation using intra-operative spinal navigation with three-dimensional isocentric C-arm fluoroscopy

Jannelli

Moiraghi

Paun

et al. 2022

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Flat Posterior Cranial Fossa Affects Outcomes of Microvascular Decompression for Trigeminal Neuralgia

Cited by 10 publications

References 33 publications

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

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

Conformation of the Posterior Fossa of the Skull: A Predisposing Factor in Patients with Hemifacial Spasm

Atlantoaxial posterior screw fixation using intra-operative spinal navigation with three-dimensional isocentric C-arm fluoroscopy

Contact Info

Product

Resources

About