Subtemporal transtentorial approach for recurrent trigeminal neuralgia after microvascular decompression via the lateral suboccipital approach: case report

Ogiwara, Toshihiro; Goto, Tetsuya; Kusano, Yoshikazu; Kuroiwa, Masafumi; Kiuchi, Takafumi; Kodama, Kunihiko; Takemae, Toshiki; Hongo, Kazuhiro

doi:10.3171/2014.10.jns132643

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…These data hypothesize Otx2 is absolutely required for normal choroid plexus development; however its importance in the general maintenance in the mature/adult choroid plexus is yet to be ascertained. It is known however in humans the obliteration of the lateral ventricular choroid plexus as a treatment for hydrocephalus results in no regeneration of the structure (Hallaert et al, 2012; Ogiwara et al, 2014). This suggests early developmental growth factor patterning cues are paramount for normal plexus development, and the structure cannot regenerate from already-present plexus epithelium.…”

Section: Normal Developmentmentioning

confidence: 99%

Development of the choroid plexus and blood-CSF barrier

2015

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Well-known as one of the main sources of cerebrospinal fluid (CSF), the choroid plexuses have been, and still remain, a relatively understudied tissue in neuroscience. The choroid plexus and CSF (along with the blood-brain barrier proper) are recognized to provide a robust protective effort for the brain: a physical barrier to impede entrance of toxic metabolites to the brain; a “biochemical” barrier that facilitates removal of moieties that circumvent this physical barrier; and buoyant physical protection by CSF itself. In addition, the choroid plexus-CSF system has been shown to be integral for normal brain development, central nervous system (CNS) homeostasis, and repair after disease and trauma. It has been suggested to provide a stem-cell like repository for neuronal and astrocyte glial cell progenitors. By far, the most widely recognized choroid plexus role is as the site of the blood-CSF barrier, controller of the internal CNS microenvironment. Mechanisms involved combine structural diffusion restraint from tight junctions between plexus epithelial cells (physical barrier) and specific exchange mechanisms across the interface (enzymatic barrier). The current hypothesis states that early in development this interface is functional and more specific than in the adult, with differences historically termed as “immaturity” actually correctly reflecting developmental specialization. The advanced knowledge of the choroid plexus-CSF system proves itself imperative to understand a range of neurological diseases, from those caused by plexus or CSF drainage dysfunction (e.g., hydrocephalus) to more complicated late-stage diseases (e.g., Alzheimer's) and failure of CNS regeneration. This review will focus on choroid plexus development, outlining how early specializations may be exploited clinically.

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Section: Normal Developmentmentioning

confidence: 99%

Development of the choroid plexus and blood-CSF barrier

2015

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“…A). This approach is often used if a retrosigmoid/suboccipital craniectomy is not optimal or if the MVD approach failed to provide pain relief . On the other hand, we found a decrease in the number of percutaneous rhizotomy procedures done to treat TN (Fig.…”

Section: Resultsmentioning

confidence: 82%

Nationwide Shift From Percutaneous Rhizotomy to Microvascular Decompression for Treatment of Trigeminal and Other Cranial Nerve Neuralgias

Kundu

Rolston

2018

Headache

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Objective The aim of this study was to report the trends in the use of common surgical interventions over the past decade to treat cranial nerve neuralgias. Methods The Centers for Medicare and Medicaid Services Part B National Summary Data File from 2000 to 2016 were studied. Results A total of 57.1 million persons were enrolled in 2016, up from 39.6 million persons in 2000. Suboccipital craniectomy done for cranial nerve decompressions (including cranial nerves V, VII, and IX) increased by 33.9 cases per year so that in 2016 the number of cases was 167% of what it was 17 years earlier (ie, from 655 cases in 2000 to 1096 cases in 2016). The less commonly used subtemporal approach craniectomy to treat trigeminal neuralgia (TN) increased by 1.13 cases per year (ie, from 25 cases in 2000 to 46 cases in 2016). The less invasive percutaneous rhizotomy procedures, including glycerol and radiofrequency ablation, for treatment of TN decreased by 42.9 cases per year (64%; ie, from 2578 cases in 2000 to 1206 cases in 2016). Conclusions Overall trends show increased use of open surgery and decreased use of percutaneous rhizotomy, including destruction of the trigeminal nerve using balloon compression, glycerol injection, or thermal injury. These trends may be related to differences in outcomes between treatment modalities.

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Section: Discussionmentioning

confidence: 99%

“…13 Recently Ogiwara et al, found it useful in cases of recurrent trigeminal neuralgia who were operated on with the standard retrosigmoid approach or when the offending vessel was distal to the root entry zone or on its anterolateral side. 11 In trigeminal schwannomas extending from the middle fossa through the porus trigeminus into the posterior fossa, the tumor medial to the internal acoustic canal can also be approached. 34 With respect to accessing the retroinfudibular/retrochiasmatic region, the location of the parasellar tumor in relation to the optic chiasm and to the pituitary stalk has to be taken into consideration during selection of the surgical approach.…”

Section: Indications For These Approachesmentioning

confidence: 99%

“…[2][3][4][5] To obviate the excessive temporal retraction needed in a basic temporal craniotomy the extended middle fossa approach with anterior petrosectomy and anterior clinoidectomy can be performed. 6 Although the anatomy of these approaches has been previously described 3,5,[7][8][9][10][11][12][13] while approaching lesions like brainstem cavernous malformations, basilar aneurysms, meningiomas, this study aimed to clarify the indications, anatomical and technical nuances pertinent to these approaches in a comparative fashion using anatomical dissections.…”

Section: Introductionmentioning

confidence: 99%

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Subtemporal Approach and Its Infratentorial Extension: Review and a Comparative Analysis of Different Techniques

Dziedzic

Abhinav

Fernández-Miranda

2022

J Neurol Surg B Skull Base

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Introduction Surgical resection of lesions occupying the incisural space is challenging. In a comparative fashion, we aimed to describe the anatomy and surgical approaches to the tentorial incisura and to the rostral brainstem via the intradural subtemporal approach and its infratentorial extensions. Methods Six fresh human head specimens (12 sides) were prepared for the microscopic dissection of the tentorial incisura using the intradural subtemporal approach and its infratentorial extensions. Endoscope was used to examine the anatomy of the region inadequately exposed with the microscope. Image-guided navigation was used to confirm bony structures visualized around the petrous apex. Results Standard subtemporal approach provides surgical access to the supratentorial brainstem above the pontomesencephalic sulcus and to the lateral surface of the cerebral peduncle. The linear or triangular tentorial divisions can provide access to the infratentorial space below the pontomesencephalic sulcus. The triangular tentorial flap in comparison with the linear incision obstructs the exposure of anterior incisural space and of the prepontine cistern. Visualization of the brainstem below the trigeminal nerve can be achieved by the anterior petrosectomy. Conclusion Infratentorial extension of the intradural subtemporal approach is technically demanding due to critical neurovascular structures and a relatively narrow corridor. In-depth anatomical knowledge is essential for the selection of the appropriate operative approach and safe surgical resections of lesions.

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Subtemporal transtentorial approach for recurrent trigeminal neuralgia after microvascular decompression via the lateral suboccipital approach: case report

Cited by 6 publications

References 15 publications

Development of the choroid plexus and blood-CSF barrier

Development of the choroid plexus and blood-CSF barrier

Nationwide Shift From Percutaneous Rhizotomy to Microvascular Decompression for Treatment of Trigeminal and Other Cranial Nerve Neuralgias

Subtemporal Approach and Its Infratentorial Extension: Review and a Comparative Analysis of Different Techniques

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