三叉神经痛纤维血管减压术.pptxVIP

Trigeminal Neuralgia,TN;DEFINITION;TRIGEMINAL NEURALGIA;CLINICAL FEATURES OF TRIGEMINAL NEURALGIA;HISTORY;HISTORY;EPIDEMIOLOGY;PATHOPHYSIOLOGY;PATHOPHYSIOLOGY;ALTERNATIVE TREATMENTS;;T1-weighted axial unenhanced magnetic resonance imaging demonstrating a Gamma Knife treatment plan for trigeminal neuralgia. ;PATIENT SELECTION AND CLASSIFICATION OF FACIAL PAIN;PREOPERATIVE IMAGING;;;a 3D CISS Imaging showing a simple contact of the SCA on the right trigeminal nerve (arrow). Note the important contrast between the CSF with hypersignal and the artery with hyposignal.;Images in a patient with right trigeminal neuralgia. Right trigeminal nerve (curved arrow) is compressed by a vessel. The vessel is identified as a vein (straight arrow), because it is visualized on contrast-enhanced MR angiographic image (b) but not on unenhanced MR angiographic image (a);;Findings In 88 cases, image analysis showed NVC features that coincided with surgical findings. There were no falsepositive results. Among 12 patients that did not show NVC at image analysis, nine did not have NVC at intraoperative observation, resulting in three false-negative cases. MRI sensitivity was 96.7% (88/91) and specificity 100% (9/9).;However, in our study, all patients had unilateral facial pain, yet 32.4% showed vascular contact or compression of the asymptomatic nerve revealed by MR imaging.;OPERATIVE ;;ANATOMY;;;;;;Motor Root And Sensory Root;Trigeminal nerve and SCA;;The superior cerebellar artery(SCA) was the cause of compression in 75% of patients, and the anterior inferior cerebellar artery(AICA) in 10%;COMPLICATIONS ;RESULTS ;Vascular compression of the trigeminal nerve is also known to occur in patients who do not have TN, and TN is known to occur in patients who have no vascular compression;;Thanks!