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https://www.readbyqxmd.com/read/29676696/tentorial-sling-for-microvascular-decompression-in-patients-with-trigeminal-neuralgia-a-description-of-operative-technique-and-clinical-outcomes
#1
Jeffrey A Steinberg, Jayson Sack, Bayard Wilson, David Weingarten, Bob Carter, Alexander Khalessi, Sharona Ben-Haim, John Alksne
OBJECTIVE Trigeminal neuralgia is a debilitating pain disorder most often caused by arterial compression of the trigeminal nerve, although there are other etiologies. Microvascular decompression (MVD) remains the most definitive treatment for this disorder, with cure rates reported between 60% and 80%. Traditional MVD techniques involve a retrosigmoid craniotomy with placement of an inert foreign material, such as Teflon, between the nerve and compressive vessel. Recurrence of trigeminal neuralgia after MVD has been associated with vessel migration, adhesion formation, and arterial pulsation against the Teflon abutting the nerve...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29660047/trigeminal-nerve-atrophy-predicts-pain-recurrence-after-gamma-knife-stereotactic-radiosurgery-for-classical-trigeminal-neuralgia
#2
Yong-Sin Hu, Cheng-Chia Lee, Wan-Yuo Guo, Chung-Jung Lin, Huai-Che Yang, Hsiu-Mei Wu, Kang-Du Liu, Wen-Yuh Chung
BACKGROUND: Trigeminal nerve atrophy and neurovascular compression (NVC) are frequently observed in classical trigeminal neuralgia (CTN). OBJECTIVE: To determine whether nerve characteristics contribute to Gamma Knife (Elekta AB, Stockholm, Sweden) surgery (GKS) outcomes in unilateral CTN without previous surgery. METHODS: From 2006 to 2012, 67 patients with unilateral CTN without previous surgery received GKS with a maximal dose of 90 Gy delivered to the trigeminal nerve juxta brainstem...
April 11, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29618114/management-of-a-previously-coiled-anterior-cerebral-artery-aneurysm-in-a-child-3-dimensional-operative-video
#3
Vijay Agarwal, Daniel L Barrow
We present the case of an 11-yr-old male who originally presented to an outside hospital with subarachnoid hemorrhage. He was discovered at that time to have a ruptured right A1-A2 junction anterior cerebral artery aneurysm just proximal to the anterior communicating artery. He underwent endovascular coiling at the outside center. While recovering at a rehabilitation center, he had a rehemorrhage and acute neurological decline. He was transferred to our service, where he underwent surgical exploration and clip reconstruction of what appeared to be a pseudoaneurysm...
March 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29617854/microsurgical-treatment-of-bowhunter-s-syndrome-3-dimensional-operative-video
#4
Vijay Agarwal, Daniel L Barrow
We present the case of a 56-yr-old previously healthy male who presented with an approximately 1-yr history of intermittent dizziness, near syncope, and holocephalic headaches when turning his head to the left side for a prolonged period of time. He had a distant history of a previous anterior cervical discectomy and fusion at the C6-7 level. He was neurologically intact. Static, dynamic, and vascular imaging confirmed hypoplasia of the right vertebral artery and dominance of the left vertebral artery that completely filled the posterior circulation...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29570006/use-of-the-apollo-detachable-tip-microcatheter-for-endovascular-embolization-of-arteriovenous-malformations-and-arteriovenous-fistulas
#5
Bruno C Flores, Alfred P See, Gregory M Weiner, Brian T Jankowitz, Andrew F Ducruet, Felipe C Albuquerque
OBJECTIVE Liquid embolic agents have revolutionized endovascular management of arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs). Nonetheless, since 2005, the US FDA has received more than 100 reports of microcatheter breakage or entrapment related to Onyx embolization, including 9 deaths. In 2014, the Apollo detachable-tip microcatheter became the first of its kind available in the US. Since then, few reports on its safety have been published. METHODS The authors conducted a retrospective review of endovascular cases by searching the patient databases at 2 tertiary cerebrovascular centers (Barrow Neurological Institute and University of Pittsburgh Medical Center)...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29510278/microvascular-decompression-for-classical-trigeminal-neuralgia-caused-by-venous-compression-novel-anatomical-classifications-and-surgical-strategy
#6
Min Wu, Xianming Fu, Ying Ji, Wanhai Ding, Dali Deng, Yehan Wang, Xiaofeng Jiang, Chaoshi Niu
BACKGROUND: Microvascular decompression (MVD) of the trigeminal nerve is the most effective treatment for trigeminal neuralgia (TN). However, when encountering with classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence due to incomplete decompression may become frequent. This study aimed to investigate the anatomical variation of the culprit veins, and discuss the surgical strategy for different types respectively...
March 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29454124/brainstem-dose-constraints-in-non-isometric-radiosurgical-treatment-planning-of-trigeminal-neuralgia-a-single-institution-experience
#7
Michael Zhang, Layton A Lamsam, Matthew K Schoen, Swapnil S Mehta, Geoffrey Appelboom, John K Adler, Scott G Soltys, Steven D Chang
INTRODUCTION: CyberKnife stereotactic radiosurgery (SRS) for trigeminal neuralgia (TGN) administers non-isometric, conformational high-dose radiation to the trigeminal nerve with risk of subsequent hypoesthesia. METHODS: We performed a retrospective, single-institution review of 66 TGN patients, treated by CyberKnife, to compare outcomes from two distinct treatment periods (standard dosing, N = 38 and reduced dosing, N = 28). Standard and reduced dosing permitted a maximum brainstem dose of 45 Gy and 25 Gy, respectively, each with a prescription dose of 60 Gy...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452326/awake-microvascular-decompression-for-trigeminal-neuralgia-concept-and-initial-results
#8
Saleem I Abdulrauf, Jorge F Urquiaga, Ritesh Patel, J Andrew Albers, Varun B Sampat, Meghan Baumer, Eric Marvin, Matthew Pierson, Raquel Kragel, Jodi Walsh
OBJECTIVE: The option of performing MVD under awake anesthesia protocol ("awake" MVD) was examined in this initial series to assess whether intraoperative pain evaluation can identify and mitigate insufficient decompression of the trigeminal nerve, improving surgical outcomes. Additionally, "awake" MVD could expand procedure indications for those with comorbidities that would prohibit general endotracheal anesthesia (GEA). METHODS: An IRB-approved prospective study of 10 consecutive adults who underwent MVD for TN was conducted...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29413360/a-sixteen-week-three-armed-randomized-controlled-trial-investigating-clinical-and-biochemical-effects-of-targeted-alterations-in-dietary-linoleic-acid-and-n-3-epa-dha-in-adults-with-episodic-migraine-study-protocol
#9
John Douglas Mann, Keturah R Faurot, Beth MacIntosh, Olafur S Palsson, Chirayath M Suchindran, Susan Ann Gaylord, Chanee Lynch, Angela Johnston, Kristen Maiden, David A Barrow, Joseph R Hibbeln, Christopher E Ramsden
Migraine is a prevalent neurological disorder, affecting over 16% of adult women and 7% of adult men in the U.S., causing significant pain, disability, and medical expense, with incomplete benefits from conventional medical management. Migraine, as a chronic pain syndrome, provides a practical model for investigating the impact of dietary modifications in omega-3 (n-3) and omega-6 (n-6) fatty acids. This paper reports the protocol of a trial to assess whether targeted dietary modifications designed to increase n-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with or without concurrent reduction in n-6 linoleic acid (LA), will alter nociceptive lipid mediators and mediate decreases in frequency and severity of migraine...
January 2018: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29397449/the-timing-of-stereotactic-radiosurgery-for-medically-refractory-trigeminal-neuralgia-the-evidence-from-diffusion-tractography-images
#10
Cheng-Chia Lee, Shin Tai Chong, Ching-Jen Chen, Sheng-Che Hung, Huai-Che Yang, Chung-Jung Lin, Chih-Chun Wu, Wen-Yuh Chung, Wan-Yuo Guo, David Hung-Chi Pan, Hsiu-Mei Wu, Jason P Sheehan, Ching-Po Lin
BACKGROUND: Diffusion tensor imaging (DTI) is a novel MRI technique that enables noninvasive evaluation of microstructural alterations in white matter of brain. Initially, DTI was used in intra- or inter-hemispheric association bundles. Recent technical advances are overcoming the challenges of imaging small white matter bundles, such as the cranial nerves. In this study, we use DTI to shed more light on the microstructure changes in long-standing trigeminal neuralgia. We also utilize DTI to study the effect of early stereotactic radiosurgery (SRS) on the microstructures of the trigeminal nerve and to predict the effectiveness of early SRS in the treatment of medically refractory trigeminal neuralgia (TN)...
February 3, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29371169/early-stereotactic-radiosurgery-for-medically-refractory-trigeminal-neuralgia
#11
Cheng-Chia Lee, Ching-Jen Chen, Shin Tai Chong, Sheng-Che Hung, Huai-Che Yang, Chung Jung Lin, Chih-Chun Wu, Wen-Yuh Chung, Wan-Yuo Guo, David Hung-Chi Pan, Hsiu-Mei Wu, Ching-Po Lin
OBJECTIVE: To evaluate effectiveness of early Gamma Knife radiosurgery (GKRS) in treatment of medically refractory trigeminal neuralgia (TN). METHODS: This retrospective review comprised 108 consecutive patients with medically refractory idiopathic TN between 2006 and 2014. All patients underwent GKRS targeting the root entry zone with a median maximum dose of 90 Gy and isodose line of 20%. Outcomes pertaining to pain and facial numbness were scored using Barrow Neurological Institute scales...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29351673/the-barrow-neurological-institute-grading-scale-as-a-predictor-for-delayed-cerebral-ischemia-and-outcome-after-aneurysmal-subarachnoid-hemorrhage-data-from-a-nationwide-patient-registry-swiss-sos
#12
Marian Christoph Neidert, Nicolai Maldaner, Martin Nikolaus Stienen, Michel Roethlisberger, Daniel W Zumofen, Donato D'Alonzo, Serge Marbacher, Rodolfo Maduri, Isabel Charlotte Hostettler, Bawarjan Schatlo, Michel M Schneider, Martin A Seule, Daniel Schöni, Johannes Goldberg, Christian Fung, Marta Arrighi, Daniele Valsecchi, Philippe Bijlenga, Karl Schaller, Oliver Bozinov, Luca Regli, Jan-Karl Burkhardt
BACKGROUND: The Barrow Neurological Institute (BNI) scale is a novel quantitative scale measuring maximal subarachnoid hemorrhage (SAH) thickness to predict delayed cerebral ischemia (DCI). This scale could replace the Fisher score, which was traditionally used for DCI prediction. OBJECTIVE: To validate the BNI scale. METHODS: All patient data were obtained from the prospective aneurysmal SAH multicenter registry. In 1321 patients, demographic data, BNI scale, DCI, and modified Rankin Scale (mRS) score up to the 1-yr follow-up (1FU) were available for descriptive and univariate statistics...
January 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29305127/7-0tesla-mri-tractography-in-patients-with-trigeminal-neuralgia
#13
Hyeong Cheol Moon, Soon-Tae You, Hyeon Man Baek, Young Jai Jeon, Chan-A Park, Jei Jun Cheong, Youn Joo Lee, Young Seok Park
7.0Tesla(T) high-resolution diffusion tensor imaging (DTI) can supply information on changing microstructures in cranial nerves. We investigated DTI parameters and the feasibility of DTI criteria for diagnosing trigeminal neuralgia (TN). In this study, 14 patients (28 hemispheres) of mean age 49.0years (range, 31-64) with TN underwent DTI using 7.0TMRI. We compared fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) of affected-side and unaffected-side trigeminal nerves using DTI...
January 2, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29174233/effectiveness-of-gamma-knife-radiosurgery-in-improving-psychophysical-performance-and-patient-s-quality-of-life-in-idiopathic-trigeminal-neuralgia
#14
Filippo Gagliardi, Alfio Spina, Michele Bailo, Nicola Boari, Andrea Cavalli, Alberto Franzin, Arianna Fava, Antonella Del Vecchio, Angelo Bolognesi, Pietro Mortini
OBJECTIVE: To assess effectiveness of Gamma Knife Radiosurgery (GKRS) in improving quality of life (QoL) in patients with idiopathic trigeminal neuralgia (TN). METHODS: Between January 2001 and October 2013, 166 patients with medically resistant TN were treated at our institution with GKRS. Patients were divided into 2 groups: patients with typical TN (TTN) and patients with atypical TN (ATN). All patients underwent clinical evaluation using Marseille and Barrow Neurological Institute pain and numbness scales; in addition, they completed the Short-Form 36 Health Survey, Activities of Daily Living, and Excellent Good Fair Poor questionnaires and underwent psychological and neurologic examination...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29170837/post-traumatic-carotid-cavernous-fistula-in-a-pediatric-patient-a-case-based-literature-review
#15
Barbara Albuquerque Morais, Vitor Nagai Yamaki, Jose Guilherme Mendes Pereira Caldas, Wellingson Silva Paiva, Hamilton Matushita, Manoel Jacobsen Teixeira
BACKGROUND: Carotid-cavernous fistula (CCF) is a shunt between the carotid artery and the cavernous sinus. Traumatic CCFs are diagnosed in 0.2% of head traumas being only 4.6% of the pediatric population. Classified by Barrow in 1985, type A CCF is the most frequent, occurring in 75% of cases. Type A is characterized by direct and high-flow CCF that generally can occur as a result of traumatic injury or rupture of an intracavernous aneurysm. CASE PRESENTATION: The subject was an 8-year-old boy with penetrating trauma to his left eye...
March 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29074316/outcome-of-gamma-knife-radiosurgery-for-trigeminal-neuralgia-associated-with-neurovascular-compression
#16
Cheng-Siu Chang, Cheng-Wei Huang, His-Hsien Chou, Long-Yau Lin, Chuan-Fu Huang
We reviewed 130 patients from 1999 to 2012 to evaluate whether neurovascular compression (NVC) has prognostic value for pain relief in idiopathic trigeminal neuralgia (TN) treated by Gamma Knife radiosurgery (GKRS). Patients were assigned to one of the following groups based on NVC identified by MRI: no NVC, small vessel NVC, and large vessel (defined as part of the vertebrobasilar arterial system) NVC. Follow-up ranged from 4 to 14years. Primary outcome was pain graded by the Barrow Neurological Institute (BNI) pain scale...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29038085/outcomes-of-two-isocenter-gamma-knife-radiosurgery-for-patients-with-typical-trigeminal-neuralgia-pain-response-and-quality-of-life
#17
Hongyang Zhao, Yin Shen, Dongxiao Yao, Nanxiang Xiong, Ahmed Abdelmaksoud, Haijun Wang
OBJECTIVE: To evaluate the effectiveness and safety of 2-isocenter Gamma Knife surgery (GKS) by reviewing patients with trigeminal neuralgia (TN) from the last 10 years. METHODS: A total of 247 patients were followed up and the Barrow Neurological Institute scale was used to evaluate pain degree. Patients' age, gender, pain duration and location, preoperative/postoperative Barrow Neurological Institute scale score, time to initial pain relief, recurrence time, and complications were documented and analyzed...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29030464/computed-tomography-interobserver-agreement-in-the-assessment-of-aneurysmal-subarachnoid-hemorrhage-and-predictors-for-clinical-outcome
#18
Peter Y M Woo, Teresa P K Tse, Robert S K Chan, Lianne N Y Leung, Stephanie K K Liu, Andrew Y T Leung, Hoi-Tung Wong, Kwong-Yau Chan
BACKGROUND: The severity of aneurysmal subarachnoid hemorrhage (SAH) is often assessed by the clinical state of the patient on presentation, but radiological evaluation of the extent of hemorrhage has rarely been examined in the literature. Several CT scan based grading systems exist yet only a few studies have investigated interobserver agreement. We evaluated five radiological grading systems and assessed their clinical value for early prognostication. METHODOLOGY: This was a retrospective study of patients diagnosed with aneurysmal SAH with a CT scan performed within 72 hours of symptom onset...
November 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28961605/radial-extracorporeal-shock-wave-therapy-in-an-individual-with-primary-trigeminal-neuralgia-a-case-report-and-literature-review
#19
Dai Zhang, Ying Meng, Hong Hai, Xiao Tong Yu, Yue Wen Ma
A patient with primary trigeminal neuralgia exhibited pain relief without medication after radial extracorporeal shock wave therapy. The 52-yr-old woman had a 3-yr history of primary trigeminal neuralgia, involving the right maxillary division (V2) and the mandibular division (V3). She became refractory to carbamazepine and exhibited hepatic dysfunction. She hence received 3000 to 6000 impulses of craniofacial radial extracorporeal shock wave therapy to the region centered on the surface projection of the trigeminal ganglion and pain areas at 10 Hz; the intensity ranged from 1...
September 28, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28953684/long-term-outcome-of-percutaneous-balloon-compression-for-trigeminal-neuralgia-patients-elder-than-80-years-a-strobe-compliant-article
#20
Xiang Ying, Hao Wang, Shanghua Deng, Yinggao Chen, Jie Zhang, Wenhua Yu
This article evaluates the long-term outcome of percutaneous balloon compression (PBC) for trigeminal neuralgia (TN) patients elder than 80 years. A total of 138 elderly patients aged above 80 years with primary TN, who were admitted to Neurosurgery Department, Hangzhou First People's Hospital from January 2007 to December 2011 for PBC treatment, were retrospectively analyzed in this study. The postoperative cure rate of immediate pain was 98.6% (Barrow Neurological Institute [BNI] classes I, II); according to the follow-up, the pain cure rates at 1, 2, 3, 4, and 5 years after surgery were 93...
September 2017: Medicine (Baltimore)
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