Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients

Sindou, Marc; Leston, J.; Howeidy, T.; Decullier, Évelyne; Chapuis, François

doi:10.1007/s00701-006-0809-2

Cited by 179 publications

(68 citation statements)

References 38 publications

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“…In order of frequency in the general population, TN occurs in the V2 and V3 distributions (30-36%), V2 distribution (10-22%), V1 and V2 distributions (17-22%), V3 distribution (15%), V1 and V2 and V3 distributions (8-12%), and V1 distribution (2-3%). 1,7,19 Trigeminal neuralgia occurs more commonly in women for reasons that are poorly understood, 1 and in the cohort of patients with isolated V2 TN in the present study, all were women, which was statistically significant. Contrary to our hypothesis, however, no difference in age was found between the isolated V2 TN cohort and the remaining 2007 TN cohort.…”

Section: Discussionsupporting

confidence: 45%

Microvascular decompression in patients with isolated maxillary division trigeminal neuralgia, with particular attention to venous pathology

Sekula

Frederickson²,

Jannetta³

et al. 2009

FOC

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Object The authors have the clinical impression that patients with isolated V2, or maxillary division, trigeminal neuralgia (TN) are most often women of a younger age with atypical pain features and a predominance of venous compression as the pathology. The aim of this study was to evaluate a specific subgroup of patients with V2 TN. Methods Among 120 patients who underwent microvascular decompression (MVD) for TN in 2007, data were available for 114; 6 patients were lost to follow-up. Patients were stratified according to typical (Burchiel Type 1), mixed (Burchiel Type 2a), or atypical (Burchiel Type 2b) TN. A pain-free status without medication was used to determine the efficacy of MVD. All patients were contacted in June 2008 and again in January 2009 at 12–24 months after surgery (median 18.4 months) and asked to rate their response to MVD as excellent (complete pain relief without medication), fair (complete pain relief with medication or some relief with or without medication), or poor (continued pain despite medication; that is, no change from their preoperative baseline pain status. Results Of 114 patients, 14 (12%) had isolated V2 TN. Among these 14 were 2 typical (14%), 1 mixed (7%), and 11 atypical cases (79%) of TN. Among the remaining 100 cases were 37 typical (37%), 14 mixed (14%), and 49 atypical cases (49%) of TN. In the isolated V2 TN group, all patients were women as compared with 72% of women in the larger group of 100 patients (p = 0.05, chi-square test). The average age in the isolated V2 TN group was 51.2 years (median 48.1 years) versus 54.2 years (median 54.0 years) in the remainder of the group (p = NS, unpaired Student t-test). In the isolated V2 TN group, there was a predominance of atypical pain cases (79%) versus 49% in the remainder of the group, and this finding trended toward statistical significance (p = 0.07, chi-square test). Venous contact or compression (partly or wholly) was noted in 93% of the patients with isolated V2 versus 69% of the remainder of the group (p = 0.13, chi-square test). The likelihood of excellent outcomes in the patients with V2 TN (71%) was compared with that in typical pain cases (79%) among patients in the rest of the group (that is, the bestoutcome group), and no difference was found between the 2 groups (p = 0.8, chi-square test). Conclusions The authors confirmed that patients with isolated V2 TN were more likely to be female, tended toward an atypical pain classification with venous pathology at surgery, and fared just as well as those presenting with typical pain.

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Section: Discussionsupporting

confidence: 45%

Microvascular decompression in patients with isolated maxillary division trigeminal neuralgia, with particular attention to venous pathology

Sekula

Frederickson²,

Jannetta³

et al. 2009

FOC

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“…In the largest published series, the one including 1,185 patients operated on by Jannetta, 70% of the patients had an excellent result 10 years after surgery [1]. Similarly, in our series of 947 patients, of whom 362 had KM analysis, the probability of cure (i.e., no pain and no medication) was 74% at 15 years of follow-up [25].…”

Section: The Neurosurgical Armamentariumsupporting

confidence: 64%

Trigeminal neuralgia: a plea for microvascular decompression as the first surgical option. Anatomy should prevail

Sindou

2009

Acta Neurochir

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“…The compression in this place can explain the TGN, nevertheless many authors suggest that the problem of neuralgia may concern all cisternal portion of the V th nerve [15,16,21,23].…”

Section: Analysis Of the Anatomical Variations Of Neurovascular Conflictmentioning

confidence: 99%

“…The percentage is approximately 0-28%, and it depends on the number of microdecompression series [1,11,17,21,23,25,30]. It is the cause why they have concluded that vascular compression may be the predominant, but not the sole cause of TGN and the pathophysiology of pain is still unclear [12,21,23]. trigeminocerebellar artery, which is the branch of BA lying between V th nerve and the hemisphere of cerebellum.…”

Section: Analysis Of the Anatomical Variations Of Neurovascular Conflictmentioning

confidence: 99%

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

Dzierżanowski

Słoniewski

2014

Folia Morphol

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Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients

Cited by 179 publications

References 38 publications

Microvascular decompression in patients with isolated maxillary division trigeminal neuralgia, with particular attention to venous pathology

Microvascular decompression in patients with isolated maxillary division trigeminal neuralgia, with particular attention to venous pathology

Trigeminal neuralgia: a plea for microvascular decompression as the first surgical option. Anatomy should prevail

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

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