PMID- 31200377
OWN - NLM
STAT- Publisher
LR  - 20240227
IS  - 1933-0693 (Electronic)
IS  - 0022-3085 (Linking)
DP  - 2019 Jun 14
TI  - Significance of degree of neurovascular compression in surgery for trigeminal 
      neuralgia.
PG  - 1-6
LID - 2019.3.JNS183174 [pii]
LID - 10.3171/2019.3.JNS183174 [doi]
AB  - OBJECTIVE: The aim of this study was to identify preoperative imaging predictors 
      of surgical success in patients with classic trigeminal neuralgia (cTN) 
      undergoing microvascular decompression (MVD) via retrospective multivariate 
      regression analysis. METHODS: All included patients met criteria for cTN and 
      underwent preoperative MRI prior to MVD. MR images were blindly graded regarding 
      the presence and severity (i.e., mild or severe) of neurovascular compression 
      (NVC). All patients were contacted by telephone to determine their postoperative 
      pain status. RESULTS: A total of 79 patients were included in this study. 
      Sixty-two patients (78.5%) were pain-free without medication following MVD. The 
      following findings were more commonly observed with the symptomatic nerve when 
      compared to the contralateral asymptomatic nerve: NVC (any form), arterial 
      compression alone, NVC along the proximal trigeminal nerve, and severe NVC (p 
      values < 0.0001). The only imaging variable that was a statistically significant 
      predictor of being pain-free without medication following MVD was severe NVC. 
      Patients with severe NVC were 6.36 times more likely to be pain-free following 
      MVD compared to those without severe NVC (p = 0.007). CONCLUSIONS: In patients 
      with cTN undergoing MVD, severe NVC on preoperative MRI is a strong predictor of 
      an excellent surgical outcome.
FAU - Hughes, Marion A
AU  - Hughes MA
AD  - Departments of1Radiology.
FAU - Jani, Ronak H
AU  - Jani RH
AD  - 2Neurosurgery, and.
FAU - Fakhran, Saeed
AU  - Fakhran S
AD  - Departments of1Radiology.
FAU - Chang, Yue-Fang
AU  - Chang YF
AD  - 2Neurosurgery, and.
FAU - Branstetter, Barton F
AU  - Branstetter BF
AD  - Departments of1Radiology.
FAU - Thirumala, Parthasarathy D
AU  - Thirumala PD
AD  - 3Neurology, University of Pittsburgh School of Medicine and University of 
      Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
FAU - Sekula, Raymond F
AU  - Sekula RF
AD  - 2Neurosurgery, and.
LA  - eng
PT  - Journal Article
DEP - 20190614
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
SB  - IM
OTO - NOTNLM
OT  - IHS = International Headache Society
OT  - MVD = microvascular decompression
OT  - NVC = neurovascular compression
OT  - SSFP = steady-state free precession
OT  - cTN = classic trigeminal neuralgia
OT  - functional neurosurgery
OT  - imaging
OT  - microvascular decompression
OT  - neurovascular compression
OT  - pain
OT  - surgical outcome
OT  - trigeminal neuralgia
EDAT- 2019/06/15 06:00
MHDA- 2019/06/15 06:00
CRDT- 2019/06/15 06:00
PHST- 2018/11/09 00:00 [received]
PHST- 2019/03/19 00:00 [accepted]
PHST- 2019/06/15 06:00 [pubmed]
PHST- 2019/06/15 06:00 [medline]
PHST- 2019/06/15 06:00 [entrez]
AID - 2019.3.JNS183174 [pii]
AID - 10.3171/2019.3.JNS183174 [doi]
PST - aheadofprint
SO  - J Neurosurg. 2019 Jun 14:1-6. doi: 10.3171/2019.3.JNS183174.