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https://www.readbyqxmd.com/read/27890181/imaging-of-vascular-compression-syndromes
#1
REVIEW
Joseph H Donahue, David A Ornan, Sugoto Mukherjee
Trigeminal neuralgia, hemifacial spasm, vestibulocochlear neuralgia and glossopharyngeal neuralgia represent the most common neurovascular compression syndromes. Repeated vascular pulsations at the vulnerable transitional zone of the individual cranial nerves lead to focal axonal injury and demyelination. High-resolution 3-D T2-weighted MR imaging is essential in detecting and mapping neurovascular compression for directed therapy. Knowledge of the specific nerve root exit, the transitional zones, and the adjacent vasculature is critical in proper management...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27884603/cranial-nerve-involvement-in-charcot-marie-tooth-disease
#2
Nirav Das, Savannah Kandalaft, Xiao Wu, Ajay Malhotra
BACKGROUND: Charcot-Marie-Tooth Disease (CMT) is a rare disorder with less than 200,000 cases reported in the US every year, making diagnosis challenging. MR and CT imaging has become more common in the evaluation of CMT to identify areas of disease involvement. CASE REPORT: A 27-year-old female from Guatemala with a past history of polio initially presented to the emergency room for necrotizing pneumonia. MRI images demonstrated smoothly enlarged, mildly enhancing trigeminal nerves...
November 21, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27833694/large-posterior-communicating-artery-aneurysm-initial-presentation-with-reproducible-facial-pain-without-cranial-nerve-deficit
#3
Stacie Zelman, Michael C Goebel, David E Manthey, Seth Hawkins
Unruptured posterior communicating artery (PCOM) aneurysms can be difficult to diagnose and, when large (≥ 7mm), represent a substantial risk to the patient. While most unruptured PCOM aneurysms are asymptomatic, when symptoms do occur, clinical manifestations typically include severe headache (HA), visual acuity loss, and cranial nerve deficit. This case report describes an atypical initial presentation of a large unruptured PCOM aneurysm with symptoms mimicking trigeminal neuralgia, without other associated cranial nerve palsies or neurologic deficits...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27770404/side-locked-headaches-an-algorithm-based-approach
#4
Sanjay Prakash, Chaturbhuj Rathore
The differential diagnosis of strictly unilateral hemicranial pain includes a large number of primary and secondary headaches and cranial neuropathies. It may arise from both intracranial and extracranial structures such as cranium, neck, vessels, eyes, ears, nose, sinuses, teeth, mouth, and the other facial or cervical structure. Available data suggest that about two-third patients with side-locked headache visiting neurology or headache clinics have primary headaches. Other one-third will have either secondary headaches or neuralgias...
December 2016: Journal of Headache and Pain
https://www.readbyqxmd.com/read/27734209/fatal-complications-following-microvascular-decompression-could-it-be-avoided-and-salvaged
#5
Lei Xia, Ming-Xing Liu, Jun Zhong, Ning-Ning Dou, Bin Li, Hui Sun, Shi-Ting Li
Although the microvascular decompression (MVD) surgery has become an effective remedy for cranial nerve rhizopathies, it is still challengeable and may result in a fatal sequel sometimes. Therefore, the operative skill needs to be further highlighted with emphasis on the safety and a preplan for management of postoperative fatal complications should be established. We retrospectively analyzed 6974 cases of MVD. Postoperatively, 46 patients (0.66 %) presented decline in consciousness with a positive finger-nose test (or failure to be tested) after wake up from the anesthesia, whom were focused on in this study...
October 12, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27676667/subtle-sensory-abnormalities-detected-by-quantitative-sensory-testing-in-patients-with-trigeminal-neuralgia
#6
Herta Flor, Dirk Rasche, Ariyan Pirayesh Islamian, Claudia Rolko, Pinar Yilmaz, Marc Ruppolt, H Holger Capelle, Volker Tronnier, Joachim K Krauss
BACKGROUND: Trigeminal neuralgia (TN) is characterized by paroxysmal pain attacks affecting the somatosensory distributions of the trigeminal nerve. It is thought to be associated with a neurovascular conflict most frequently, but pathomechanisms have not been fully elucidated. In general, no sensory deficit is found in routine clinical examination. There is limited data available, however, showing subtle subclinical sensory deficits upon extensive testing. OBJECTIVE: We used quantitative sensory testing (QST) to detect abnormalities in sensory processing in patients with TN by comparing the affected and non-affected nerve branches with their contralateral counterparts and by comparing the results of the patients with those of controls...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27593849/long-term-therapeutic-effect-of-microvascular-decompression-for-trigeminal-neuralgia-kaplan-meier-analysis-in-a-consecutive-series-of-425-patients
#7
Yongxu Wei, Chunhua Pu, Ning Li, Yu Cai, Hanbing Shang, Weiguo Zhao
AIM: This study evaluated the long-term efficacy and safety of microvascular decompression (MVD) for treating trigeminal neuralgia (TN), and identified the predictors of pain relief. MATERIAL AND METHODS: A total of 425 patients who underwent surgery between 1991 and 2011 for idiopathic TN were included in this study. Pain outcome was graded using the Barrow Neurological Institute pain scale, success was defined as complete pain relief without medication. A Kaplan-Meier survival curve was generated...
August 5, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27593717/isolated-deep-ear-canal-pain-possible-role-of-the-auricular-branch-of-the-vagus-nerve-case-illustrations-with-cadaveric-correlation
#8
Kentaro Watanabe, R Shane Tubbs, Shunsuke Satoh, Ali R Zomorodi, Wolfgang Liedtke, Moujahed Labidi, Allan H Friedman, Takanori Fukushima
: Glossopharyngeal, nervus intermedius and vagus neuralgias can all present with ear pain. However, to our knowledge, there have been no reports of otalgia as the only symptom of vagus neuralgia. The seventh, ninth and tenth cranial nerves have many interneural connections and the exact anatomy and pathophysiology of these neuralgias is often not clear. Moreover, symptoms due to involvement of any of these nerves can be difficult to attribute solely to one of them. The overlapping sensory innervation of the external auditory canal can lead to misdiagnosis in patients suffering from otalgia...
September 1, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27533070/a-novel-pathophysiological-mechanism-contributing-to-trigeminal-neuralgia
#9
Giovanni Grasso, Alessandro Landi, Concetta Alafaci
Trigeminal neuralgia (TN) is a form of neuropathic pain that affects the fifth cranial nerve, the most widely distributed nerve in the head. Although TN has been associated with a variety of pathological conditions, neurovascular compression on the trigeminal nerve, as it exits the brain stem, is the most frequent reported cause. This compression provides a progressive demyelination of the nerve and a subsequent aberrant neural transmission. Although several studies have clarified some physiopathological mechanisms underlying TN, the molecular basis remains vague...
August 11, 2016: Molecular Medicine
https://www.readbyqxmd.com/read/27518528/utility-of-the-intensive-care-unit-in-patients-undergoing-microvascular-decompression-a-multiinstitution-comparative-analysis
#10
Jesse D Lawrence, Chad Tuchek, Aaron A Cohen-Gadol, Raymond F Sekula
OBJECTIVE Use of the ICU during admission to a hospital is associated with a significant portion of the total health care costs for that stay. Patients undergoing microvascular decompression (MVD) for cranial neuralgias are routinely admitted postoperatively to the ICU for monitoring. The primary purpose of this study was to compare complication rates of patients with and without a postoperative ICU stay following MVD. The secondary intents were to identify predictors of complications, to analyze variables of health care resource utilization, and to estimate the cost of postoperative management...
August 12, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27475511/cranial-neuralgias
#11
REVIEW
Zahid H Bajwa, Sarah S Smith, Shehryar N Khawaja, Steven J Scrivani
Advances in diagnostic modalities have improved the understanding of the pathophysiology of neuropathic pain involving head and face. Recent updates in nomenclature of cranial neuralgias and facial pain have rationalized accurate diagnosis. Clear diagnosis and localization of pain generators are paramount, leading to better use of medical and targeted surgical treatments.
August 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27330875/the-continuous-assessment-of-cranial-motion-in-thermoplastic-masks-during-cyberknife-radiosurgery-for-trigeminal-neuralgia
#12
Tewfik J Bichay, Alan Mayville
Stereotactic radiosurgery (SRS) treatment is characterized by high doses per fraction and extremely steep dose gradients. This requires a great degree of accurate localization to the appropriate treatment position, and continuous immobilization during the treatment session. In the case of Trigeminal Neuralgia (TGN) treatment this is especially true as the very small target volume makes positional accuracy critical. In this study we carried out a quantitative analysis of patient motion during the full treatment fraction within a radiosurgery immobilization mask system...
2016: Curēus
https://www.readbyqxmd.com/read/27324998/the-role-of-imaging-for-trigeminal-neuralgia-a-segmental-approach-to-high-resolution-mri
#13
REVIEW
Daniel P Seeburg, Benjamin Northcutt, Nafi Aygun, Ari M Blitz
High-resolution MRI affords exquisite anatomic detail and allows radiologists to scrutinize the entire course of the trigeminal nerve (cranial nerve [CN] V). This article focuses first on the normal MRI appearance of the course of CN V and how best to image each segment. Special attention is then devoted to the role of MRI in presurgical evaluation of patients with neurovascular conflict and in identifying secondary causes of trigeminal neuralgia, including multiple sclerosis. Fundamental concepts in postsurgical imaging after neurovascular decompression are also addressed...
July 2016: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27324997/endoscopic-and-microscopic-microvascular-decompression
#14
REVIEW
Matthew Piazza, John Y K Lee
The introduction of the endoscope into the neurosurgeon's armamentarium has revolutionized ventral and anterior skull-base surgery and, more recently, has been used in the surgical treatment of cerebellopontine angle (CPA) pathology. The utilization of the endoscope in microvascular decompression (MVD) for trigeminal neuralgia and other associated cranial nerve hyperactivity syndromes allows for unparalleled panoramic views and illumination of the neurovascular structures within the CPA and identification of vessel-nerve contact traditionally unseen using the microscope...
July 2016: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27321865/sleep-disorders-and-chronic-craniofacial-pain-characteristics-and-management-possibilities
#15
Galit Almoznino, Rafael Benoliel, Yair Sharav, Yaron Haviv
Chronic craniofacial pain involves the head, face and oral cavity and is associated with significant morbidity and high levels of health care utilization. A bidirectional relationship is suggested in the literature for poor sleep and pain, and craniofacial pain and sleep are reciprocally related. We review this relationship and discuss management options. Part I reviews the relationship between pain and sleep disorders in the context of four diagnostic categories of chronic craniofacial pain: 1) primary headaches: migraines, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs) and hypnic headache, 2) secondary headaches: sleep apnea headache, 3) temporomandibular joint disorders (TMD) and 4) painful cranial neuropathies: trigeminal neuralgia, post-herpetic trigeminal neuropathy, painful post-traumatic trigeminal neuropathy (PTTN) and burning mouth syndrome (BMS)...
May 11, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/27260489/standardized-reporting-of-adverse-events-after-microvascular-decompression-of-cranial-nerves-a-population-based-single-institution-consecutive-series
#16
Jiri Bartek, Sasha Gulati, Geirmund Unsgård, Clemens Weber, Petter Förander, Ole Solheim, Asgeir S Jakola
OBJECTIVE: To investigate frequencies of adverse events occurring within 30 days after microvascular decompression (MVD) surgery using a standardized report form of adverse events. METHODS: We conducted a retrospective review of 98 adult patients (≥16 years) treated with MVD between 1 January 1994 and 1 June 2013. Adverse events occurring within 30 days were classified according to the Landriel Ibanez classification for neurosurgical complications: grade I represents any non-life threatening complication treated without invasive procedures; grade II is complications requiring invasive management; grade III is life-threatening adverse events requiring treatment in an intensive care unit (ICU); grade IV is death as a result of complications...
September 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27213105/microvascular-decompression-for-glossopharyngeal-neuralgia-through-a-microasterional-approach-a-case-series
#17
REVIEW
Rogelio Revuelta-Gutiérrez, Andres Humberto Morales-Martínez, Carolina Mejías-Soto, Jaime Jesús Martínez-Anda, Luis Alberto Ortega-Porcayo
BACKGROUND: Glossopharyngeal neuralgia (GPN) is an uncommon craniofacial pain syndrome. It is characterized by a sudden onset lancinating pain usually localized in the sensory distribution of the IX cranial nerve associated with excessive vagal outflow, which leads to bradycardia, hypotension, syncope, or cardiac arrest. This study aims to review our surgical experience performing microvascular decompression (MVD) in patients with GPN. METHODS: Over the last 20 years, 14 consecutive cases were diagnosed with GPN...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27188665/varicella-zoster-virus-infection
#18
Anne A Gershon, Judith Breuer, Jeffrey I Cohen, Randall J Cohrs, Michael D Gershon, Don Gilden, Charles Grose, Sophie Hambleton, Peter G E Kennedy, Michael N Oxman, Jane F Seward, Koichi Yamanishi
Infection with varicella zoster virus (VZV) causes varicella (chickenpox), which can be severe in immunocompromised individuals, infants and adults. Primary infection is followed by latency in ganglionic neurons. During this period, no virus particles are produced and no obvious neuronal damage occurs. Reactivation of the virus leads to virus replication, which causes zoster (shingles) in tissues innervated by the involved neurons, inflammation and cell death - a process that can lead to persistent radicular pain (postherpetic neuralgia)...
July 2, 2015: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27179388/vagoglossopharyngeal-neuralgia-revealed-through-predominant-digestive-vagal-manifestations-case-report-and-literature-review
#19
P Antherieu, F Vassal, M Sindou
Vagoglossopharyngeal neuralgia is a rare pathology whose atypical forms, dominated by syncopal manifestations, are still rarer. Although the territory of the vagus nerve involves, beyond the cardiovascular system, the respiratory and the digestive systems, there is no report in literature of atypical forms other than syncopal. Therefore, the authors were prompted to report the case of a patient whose vagoglossopharyngeal neuralgia was predominantly revealed by digestive symptoms. A 58-year-old patient presented with stereotypical severe digestive disturbances including nausea, vomiting and diarrhoea...
June 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/27157289/new-clinical-and-morphologic-aspects-in-trigeminal-neuralgia
#20
Levent Tanrikulu, Peter Hastreiter, Teresa Bassemir, Barbara Bischoff, Michael Buchfelder, Arnd Dörfler, Ramin Naraghi
OBJECTIVE: High-resolution magnetic resonance imaging can be used to delineate the morphology of neurovascular compression (NVC) in detail. This study focuses on essential morphologic parameters in relation to the clinical appearance of patients with trigeminal neuralgia (TN). METHODS: A total of 180 patients with TN underwent magnetic resonance-constructive interference in steady state/time of flight. Parameters of the affected nerves (length) and causative vessels were examined: (1) the relationship between the NVC site (caudal/cranial/laterocaudal/mediocranial) and affected area (V1, V2, V3); (2) nerve deformity; (3) vascular loop; (4) existence of a "cerebrospinal fluid (CSF) sign" by a separation of trigeminal fascicles by a vessel; and (5) localization of the causative vessel...
August 2016: World Neurosurgery
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