No abstract

Objective: To explore the clinical characteristics of patients with recurrent trigeminal neuralgia (TN) and the experience of microvascular decompression (MVD) in the treatment of such patients.Methods: We retrospectively analyzed clinical data, imaging examination results, surgical methods, and treatment efficacies in 127 patients with recurrent typical TN from January 2005 to December 2014.Results: The age of the recurrent group was higher than that of the non-recurrent group (p < 0.05). The duration of pain before the first MVD procedure was longer in the recurrent group than in the non-recurrent group (p < 0.05). Patients in the recurrent group were more likely to have compression of the trigeminal nerve by the vertebrobasilar artery (VBA) or multiple vessels than patients in the non-recurrent group (p < 0.05). A Kaplan–Meier curve showed a median pain-free survival of 12 months after the first MVD procedure. The severity of pain (preoperative visual analog scale [VAS] score) in patients with recurrence was lower than that in patients with first-onset TN (p < 0.05). Vessel compression, Teflon compression or granuloma and arachnoid adhesion were considered the main causes of recurrence. Postoperative Barrow Neurological Institute (BNI) scores in the redo MVD group were excellent (T = 2) for 69 patients (53.33%) and good (T = 3) for 46 patients (36.22%). The postoperative follow-up was 63–167 months (105.92 ± 25.66). During the follow-up, no recurrence was noted. All complications were cured or improved.Conclusions: Microvascular decompression (MVD) is an effective surgical method for the treatment of TN. For recurrent patients, reoperation can achieve good results.

Background/Aims: The coexistence of scoliosis and split cord malformation (SCM) is often encountered. The characteristics of the osseous septum of SCM are still unknown to us. Here we try to delineate the configuration and nature of the osseous septa. The correlation between scoliosis and SCM is also discussed. Methods: 48 patients hospitalized for scoliosis were studied. SCM was subsequently identified in all of the patients. These patients underwent operations and were retrospectively evaluated. Results: The figuration, component, location and nature of osseous septa are described. 47 of the 48 SCMs (98%) were type I. Only 1 case was type II. 43 patients (90%) had 1 osseous septum. The other 5 patients (10%) had 2 osseous septa at different levels. 41 septa (78%) were mainly made of cortical bone, another 6 septa (11%) were mainly made of cancellous bone, while the other 6 (11%) were bone together with soft tissues. The prominent central blood vessels were found in 19 cases (36%). 10 osseous septa (19%) were derived from neural arches. 15 osseous septa (28%) were from both vertebral bodies and neural arches. Conclusion: We assumed that SCM might contribute to the progress of scoliosis. It is recommended that removal of the spur be carried out before corrective surgery on the spine.

Objective: To investigate whether small volumes of the posterior cranial fossa and cerebellopontine cisterns are associated with bilateral trigeminal neuralgia (BTN) and to provide further knowledge regarding the etiology and treatment of this rare disease. Methods: We retrospectively analyzed clinical data and imaging examination results for 30 BTN patients between January 2009 and December 2019. Thirty age-and sex-matched healthy individuals and 30 patients with unilateral trigeminal neuralgia (UTN) were selected as two control groups. The volume of the posterior cranial fossa (VPCF) and volumes of the cerebellopontine cisterns were measured using ITK-SNAP 3.0, which considers the cerebrospinal fluid (CSF) volume based on the region of interest (ROI). Preoperative and postoperative statuses were based on visual analog scale (VAS) pain scores and Barrow Neurological Institute (BNI) scores. Conclusion: Overcrowding in the posterior fossa will lead to closer neurovascular relations and, a higher incidence of NVC, and ultimately may be more likely to lead to TN. Veins are the common offending vessels that cause BTN; they might be associated with abnormal vascular development leading to NVC. Microsurgical vascular decompression (MVD) is a safe and effective method for the treatment of BTN, similar to UTN.

Spontaneous intracerebral hemorrhage (ICH) is associated with high mortality and disability rates. The microglia-induced inflammatory response is a critical factor determining brain tissue damage after ICH. Raddeanin A (RA) is a natural triterpenoid compound with anti-inflammatory effects, although its effects on ICH and the underlying molecular mechanism have not been elucidated. In this study, we found that RA reduced the volume of cerebral hematoma and cerebral edema, attenuated neuronal apoptosis and improved the behavioral indices in a murine model of acute cerebral hemorrhage. Mechanistically, RA downregulated the TLR4-mediated pro-inflammatory effectors, reduced infiltration of microglia in peri-intracerebral hemorrhage and inhibited apoptosis of neurons co-cultured with activated microglia. In conclusion, RA can alleviate ICH-related tissue damage and promote the recovery of neuronal function by suppressing microglia-induced inflammation and apoptosis.