Late Results of Gangliolysis as a Treatment for Trigeminal Neuralgia

Stender, A; Grumme, Th.

doi:10.3171/jns.1969.31.1.0021

Cited by 8 publications

(1 citation statement)

References 21 publications

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“…Stender intensively studied the indications for lumbar disc surgery. He applied the technique of gangliolysis in trigeminal neuralgia (73) but also practiced psychosurgery, namely transorbital leukotomy (72). Excellent specialists emerged from his unit, such as the neurologist Hans Schliack and the neuroradiologist Sigurd Wende.…”

Section: Evolution Of Neurosurgery In West Germany Surgical Neurologistsmentioning

confidence: 99%

Historical Perspective on Neurosurgery in Germany After World War Ii

Collmann

Vitzthum

2008

Neurosurgery

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AFTER THE COLLAPSE of the Third Reich, the specialty of neurosurgery in Germany, although well developed in the late 1930s, had to start anew, and for decades to come, had to deal with the physical and political consequences of World War II. Because of the division of the country, neurosurgery developed separately in the two independent states. In West Germany, the evolution was promoted by a few personalities who represented different schools according to their own training: these "surgical neurologists" emphasized the neurological basis of neurosurgery and were represented by Traugott Riechert and the students of Otfrid Foerster, such as Arist Stender and Hans Kuhlendahl. In contrast, the "neurological surgeons" stressed their origins in general surgery. Their main proponent was Wilhelm Tönnis, who gained particular merit for promoting neurosurgical teaching, the development of new neurosurgical units, and the recognition of neurosurgery as an autonomous specialty. In East Germany, progress was delayed by a weak economy and a repressive political system. Yet several excellent neurosurgeons won international recognition, predominantly Georg Merrem, who came from the school of Fedor Krause. Following a worldwide trend, the number of neurosurgical units in West Germany increased dramatically from 18 in 1950 to 85 in 1988. In 2006, in the unified nation, 1200 certified neurosurgeons in 138 hospital departments and 75 private practices served 82 million people. Since its founding in 1949, the German Neurosurgical Society has promoted the idea of reconciliation and has focused on international collaboration in both science and education. This idea, shared by other European nations, eventually gave rise to the European Association of Neurosurgical Societies. At present, escalating costs in the health sector pose a problem to neurosurgical services and have led to reconsiderations about their structure and financing.

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Section: Evolution Of Neurosurgery In West Germany Surgical Neurologistsmentioning

confidence: 99%

Historical Perspective on Neurosurgery in Germany After World War Ii

Collmann

Vitzthum

2008

Neurosurgery

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How does vascular decompression surgery improve trigeminal neuralgia?

Tenser

1986

Annals of Neurology

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Surgical decompression of blood vessels impinging on the trigeminal root has been described for the treatment of trigeminal neuralgia 141. While the decompression procedure may alleviate symptoms, it is likely that the surgery has effects other than merely lifting free the vessel thought to be compressing. Evidence favoring this view is provided by studies of herpes simplex virus (HSV).It has been known for many years that trigeminal root section for the treatment of trigeminal neuralgia may result in activation of latent HSV in trigeminal ganglia 1.11. Latent HSV resides in neurons in the trigeminal ganglia [7]. During rhizotomy procedures, it is likely that root section or manipulation of trigeminal ganglion neurons results in the activation of latent ganglionic virus. This letter emphasizes that similar activation of latent HSV was frequently noted after vascular decompression of the trigeminal root for the treatment of trigeminal neuralgia 141.HSV activation is likely due to stimulation of or damage to trigeminal ganglion neurons, or both. Lessening of pain might be due to similar neuronal mechanisms rather than to decompression per se. For example, application of neurosurgical balloon technology can reduce the pain of trigeminal neuralgia 131. Others have also concluded that mechanical trauma or manipulation of the sensory root is important for the relief of trigeminal neuralgia 15, 61. Recently, percutaneous injection of the trigeminal cistern with glycerol has been reported to alleviate trigeminal neuralgia, and also may lead to the reactivation of HSV 121. These comments are not meant to detract from the reported improvement in pain after trigeminal root decompression but do suggest that removal of putative compressing vessels from nerve roots may not be the mechanism of improvement. RefevenceJ1. Carton CA, Clbourne ED: Activation of latent herpes simplex by trigeminal sensory-root section. N Engl J Med 246:172-176, 1952 2. Lunsford LD, Bennett MH: Percutaneous retrogasserian glycerol rhizotomy for tic douloureux: part 1. Neurosurgery 14:424-429, 1084 3 . Mullen S, Duda EE, Patronas NJ: Some examples of balloon technology in neurosurgery. J Neurosurg 52:321-329, 1980 4. Pain GJ, Ho M, Jannetta PJ: Reactivation of herpes simplex virus after decompression of the trigeminal nerve root. J Infect Dis 138:405-409, 1978 5. Shelden CH, Pudenz RH, Freshwater DB, Crue BL Compression rather than decompression for trigeminal neuralgia. J Neurosurg 12: 123-126, 1955 6. Stender A, Grumme 7. Late results of gangliolysis as a treatmenf of trigeminal neuralgia. J Neurosurg 31:21-24, 1969 7. Tenser RB, Dawson M, Ressel SJ, Dunstan ME: Detection ol' herpes simplex virus mRNA in latently infected trigeminal ganglion neurons by in situ hybridization. Ann Neurol 11:285-291, 1982 T --Although loss of consciousness is a well-recognized feature of basilar artery migraine [ l}, there are remarkably few accounts in which systematic clinical observations have been made and an electroencephalogram (EEG) has been recorded during such ...

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