PainTrigeminal neuralgia: What are the important factors for good operative outcomes with microvascular decompression
Section snippets
Patients and methods
Between 2000 and 2002, 62 patients with TN were admitted and treated first by microvascular decompression at the Department of Neurosurgery, Tongji Hospital of Tongji University. On admission, each patient's history and clinical condition were checked and recorded in detail, including sex, age, initial symptoms, durations, trigger points, pain distribution and characteristics, and past treatment. Of these patients, their clinical presentations were divided into typical and atypical TN. Typical
Operative findings
Of 62 patients, artery compression was found in 47 patients, artery compression in combination with venous compression occurred in 13 patients, and the offending vessels could not be named in 2 patients (Table 1).
The neurovascular conflicts were as follows. Single contact between offending vessel and trigeminal nerve was found in 14 (22.6%) patients. Contact and indentation occurred in 7 (11.3%) patients. Single adhesion was encountered in 15 (24.2%) patients, while adhesion and indentation
Discussion
As shown in the present study, microvascular decompression is a safe and effective method in treating TN, even if the facial pain is very severe and intractable with medications or other treatments before microvascular decompression. Unfortunately, we do not have good records regarding the methods and outcomes of these patients' past treatments such as medications, percutaneous ablation, trigeminal nerve neurectomy, radiation therapy, etc., but the past treatments seemed to have no clear
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