Preoperative MRI in neurovascular compression syndromes and its role for microsurgical considerations

Tanrikulu, Levent; Scholz, Torben; Nikoubashman, Omid; Wiesmann, Martin; Clusmann, Hans

doi:10.1016/j.clineuro.2014.11.005

Cited by 26 publications

(17 citation statements)

References 13 publications

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“…There was a diagnostic correspondence in the evaluation of 1.5 T with T2 fast spin echo and intraoperative findings. [ 96 ] Garcia et al . demonstrated that there is a higher resolution and greater sensitivity with 3D-CISS and 3D-TOF MRA at 3 T compared with 1.5 T in patients with NVC.…”

Section: Resultsmentioning

confidence: 99%

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Martins¹,

Albuquerque²,

Carvalho³

et al. 2017

Surg Neurol Int

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Background:Bilateral hemifacial spasm (BHFS) is a rare neurological syndrome whose diagnosis depends on excluding other facial dyskinesias. We present a case of BHFS along with a literature review.Methods:A 64-year-old white, hypertense male reported involuntary left hemiface contractions in 2001 (aged 50). In 2007, right hemifacial symptoms appeared, without spasm remission during sleep. Botulinum toxin type A application produced partial temporary improvement. Left microvascular decompression (MVD) was performed in August 2013, followed by right MVD in May 2014, with excellent results. Follow-up in March 2016 showed complete cessation of spasms without medication.Results:The literature confirms nine BHFS cases bilaterally treated by MVD, a definitive surgical option with minimal complications. Regarding HFS pathophysiology, ectopic firing and ephaptic transmissions originate in the root exit zone (REZ) of the facial nerve, due to neurovascular compression (NVC), orthodromically stimulate facial muscles and antidromically stimulate the facial nerve nucleus; this hyperexcitation continuously stimulates the facial muscles. These activated muscles can trigger somatosensory afferent skin nerve impulses and neuromuscular spindles from the trigeminal nerve, which, after transiting the Gasser ganglion and trigeminal nucleus, reach the somatosensory medial posterior ventral nucleus of the contralateral thalamus as well as the somatosensory cortical area of the face. Once activated, this area can stimulate the motor and supplementary motor areas (extrapyramidal and basal ganglia system), activating the motoneurons of the facial nerve nucleus and peripherally stimulating the facial muscles.Conclusions:We believe that bilateral MVD is the best approach in cases of BHFS.

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Section: Resultsmentioning

confidence: 99%

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Martins¹,

Albuquerque²,

Carvalho³

et al. 2017

Surg Neurol Int

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“…Review of 803 titles, 255 abstracts, and 92 fulltext articles resulted in the inclusion of 35 articles. [2][3][4][5][6]8,[13][14][15][16][18][19][20]22,23,25,[27][28][29][30]33,34,[35][36][37][38][39][40][41][43][44][45][46][47]49 Special care was taken to avoid including studies with potentially overlapping participants (16 studies were excluded for this reason). For an overview of the selection process, see the PRISMA-IPD flow diagram (Fig.…”

Section: Study Selectionmentioning

confidence: 99%

“…Individual patient data were adequately reported in 25 studies. 2,4,5,8,[13][14][15][16]18,19,23,25,[27][28][29][30]35,[37][38][39][40][43][44][45][46][47] From the remaining 10 studies, IPD were requested. This resulted in the inclusion of IPD from 2 more studies in the IPD analysis 3,36 ( Fig.…”

Section: Meta-analysis Of Individual Patient Datamentioning

confidence: 99%

Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data

Berge

Dijk²,

Posthumus³

et al. 2017

Journal of Neurosurgery

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OBJECTIVE Microvascular decompression (MVD) is regarded as a valid treatment modality in neurovascular conflicts (NVCs) causing, for example, trigeminal neuralgia and hemifacial spasms. An NVC of the cochleovestibular nerve might cause tinnitus and/or vertigo; however, general acceptance of MVD for this indication is lacking. The aim of this study was to investigate the effectiveness, safety, and prognostic factors for success of MVD of the cochleovestibular nerve. METHODS A systematic review and meta-analysis of individual patient data (IPD) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Individual Patient Data (PRISMA-IPD) guidelines. By a comprehensive search (conducted in January 2016) in MEDLINE, EMBASE, and Google Scholar, eligible studies were identified. The collected outcome was a global measurement of improvement of 1) tinnitus, 2) vertigo, and 3) tinnitus combined with vertigo. For the meta-analysis, IPD were collected from the papers and/or from the authors. IPD were analyzed with logistic regression analysis while accounting for study clustering. RESULTS Thirty-five studies (572 patients) were included. The level of evidence provided by these studies was low. In 28% of patients with tinnitus and 32% of patients with vertigo, complete relief following MVD was reported. Patients with both tinnitus and vertigo had complete relief in 62% of cases. In 11% of patients, ≥ 1 complications were reported. Meta-analysis of IPD (165 patients) demonstrated that patients with both tinnitus and vertigo had a higher chance of success (OR 3.8, 95% CI 1.45-10.10) than patients with tinnitus alone. No other variables were significantly related to success. CONCLUSIONS Due to low success rates, MVD cannot be considered as a standard treatment method for tinnitus or vertigo. Moreover, a substantial complication rate was found. However, patients with combined symptoms had a higher chance of success. When combined symptoms occur, it is more likely that an NVC is the underlying pathology and MVD might be appropriate. Due to the low level of evidence in the included studies, this conclusion must be taken with caution. Further validation is necessary to evaluate whether patients with combined symptoms are indeed better candidates for MVD.

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“…Neurovascular compression syndromes are caused by pathological neurovascular conflicts at the root entry zone (REZ) of the corresponding cranial nerves in the posterior fossa [1,2]. Trigeminal neuralgia (TN; compression of cranial nerve V) and hemifacial spasm (HFS; compression of cranial nerve VII) are the most commonly diagnosed neurovascular compression syndromes.…”

Section: Introductionmentioning

confidence: 99%

Preoperative visualization of neurovascular contact with 3D-FIESTA combined with 3D-TOF MRA to guide microvascular decompression surgery planning

Liu¹,

Shi²,

Li³

et al. 2020

Journal of Neurorestoratology

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Background:Neurovascular compression syndromes including trigeminal neuralgia (TN) and hemifacial spasm (HFS) are caused by neurovascular conflicts at the root entry zone of the corresponding cranial nerves in the posterior fossa. Microvascular decompression (MVD) is the best choice for the treatment of TN and HFS. An accurate delineation of the responsible vessel could decrease the rate of possible operative complications such as nerve paresis.Methods:In this study, three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) were performed on 113 patients with TN or HFS. The imaging data were compared to the intraoperative findings and the accuracy of the data was calculated among the different responsible blood vessels and disease types. The accuracy of the data among different genders, disease durations, disease sides, and disease types was also calculated to identify the target patients for the preoperative diagnostic approach with 3D-FIESTA combined with 3D-TOF MRA.Results:The accuracy of detection with the imaging was above 75% in cases with single-vessel compression. Among these, the accuracy of the preoperative imaging result was the highest when the lesions were in the superior cerebellar artery (SCA; 91.1%). In cases of multiple-vessel compression, however, the coincidence between the preoperative and intraoperative results was only 30.0%. In most of the cases of TN, the responsible blood vessels were in the SCA, and the accuracy in the SCA reached 94.9%. In HFS patients, the responsible blood vessels were in the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA), and the accuracy was 86.8% and 90.0%, respectively. The differences in the accuracy of the data among different genders, disease durations, disease sides, and disease types were not statistically significant.Conclusion:This study verified the clinical instructional value of 3D-FIESTA combined with 3D-TOF MRA in MVD, and showed that this preoperative examination is reliable for all genders, disease durations, disease sides, and disease types.

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Preoperative MRI in neurovascular compression syndromes and its role for microsurgical considerations

Cited by 26 publications

References 13 publications

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data

Preoperative visualization of neurovascular contact with 3D-FIESTA combined with 3D-TOF MRA to guide microvascular decompression surgery planning

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