Vertebrobasilar dolichoectasia as a cause of trigeminal neuralgia: the role of microvascular decompression. Case report

Kraemer, Jorge Luiz; Filho, Arthur de Azambuja Pereira; David, Gustavo de; Faria, Mário de Barros

doi:10.1590/s0004-282x2006000100027

Cited by 23 publications

(11 citation statements)

References 25 publications

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“…Dolikoektazi hastalarındaki trigeminal nevralji insidansı %0.9 ile %5.7 arasında bildirilmektedir. [9,10] VBD'ler, trigeminal nevraljinin en nadir nedenleri arasındadır. Piatt ve ark.…”

Section: Discussionunclassified

“…VBD'ye bağlı başağrısı olguları oldukça nadirdir ve genellikle tri-PAIN A RI geminal nevralji kliniği ile prezente olurlar. [8][9][10][11] Literatürde, bildiğimiz kadarıyla, VBD'ye ikincil gelişen bir hemkrani ya da sürekli bir yüz ağrısı olgusu daha önce rapor edilmemiştir. Bu yazıda, ağrı nedeniyle başvuran ve görüntüleme sonucunda VBD'si tespit edilen iki olgunun klinik ve radyolojik özellikleri ile sunulması amaçlanmıştır.…”

Section: Introductionunclassified

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Vertebrobasilar artery dolichoectesia and pain; coincidence or etiology ?

Alemdar¹

2016

Agri

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ÖzetDolikoektazi arterlerin uzaması, genişlemesi ve büküntülü hale gelmesi olarak tanımlanır. En sık etkilenen damarlar; intrakranial vertebral ve baziler arterlerdir. Vertebrobaziler arter dolikoektazisi genellikle asemptomatiktir. Semptomatik olgularda, serebral iskemi, kanama ya da kitle etkisine bağlı bası bulguları görülür. Literatürde beşinci kraniyel sinir basısına bağlı olarak gelişen trigeminal nevralji ile ilgili olgu sunumları mevcut ise de, bildiğimiz kadarıyla, vertebrobaziler arter dolikoektazisine ikincil gelişen hemikrani veya sürekli bir yüz ağrısı daha önce rapor edilmemiştir. Burada, sağ tarafta sürekli yarım başağrısı şikayeti ile başvuran vertebrobaziler arter dolikoektazili 42 yaşında bir erkek hasta ve onun yeğeni olan, sağda sürekli fasiyel ağrı ile başvuran 19 yaşında bir kadın hasta sunuldu.Anahtar sözcükler: Ağrı; başağrısı; dolikoektazi; vertebrobaziler. SummaryDolichoectesia is described as elongation, widening, and tortuosity of an artery. Most commonly involved vessels are the intracranial vertebral and basilar arteries. Vertebrobasilar artery dolichoectesia is usually asymptomatic. Cerebral ischemia, hemorrhage, or compression findings due to mass effect can be seen in symptomatic patients. Although there are case reports of trigeminal neuralgia due to fifth cranial nerve compression in the literature, to the best of our knowledge, neither hemicranial nor continuous facial pain secondary to vertebrobasilar artery dolichoectesia has been reported previously. Presently described is case of a 42-year-old male with vertebrobasilar dolichoectesia who had complaint of continuous right-sided hemicranial pain, and his 19-year-old niece, who presented with continuous right-sided facial pain.

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Section: Discussionunclassified

Section: Introductionunclassified

Vertebrobasilar artery dolichoectesia and pain; coincidence or etiology ?

Alemdar¹

2016

Agri

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“…The use of polytetrafluoroethylene pledgets is an established procedure in neurosurgery to avoid nerve compression by pulsative intracranial arteries [11,13,16,22,25]. Furthermore, polytetrafluoroethylene membranes are used to decrease epidural and peridural scarring after spinal surgery [10,14,15].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Piriformis Syndrome After Surgical Release

Kobbe

Zelle

Gruen

2008

Clinical Orthopaedics &Amp; Related Research

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Piriformis syndrome is an uncommon condition characterized by sciatic nerve entrapment at the greater sciatic notch. Nonoperative treatment such as physical therapy, nonsteroidal antiinflammatory drugs, and local injections often results in relief of symptoms. For patients who do not benefit from nonoperative therapy, surgical exploration and decompression of the sciatic nerve has been effective. However, the success of surgery may be diminished by scar formation or hematoma in the anatomically restricted sciatic notch. We report two patients with piriformis syndrome who responded primarily to surgical decompression and had recurrent symptoms resulting from scar tissue formation in the sciatic notch. On revision surgery, polytetrafluoroethylene pledgets were placed around the sciatic nerve to avoid compression and entrapment by scar tissue. Both patients had satisfactory outcomes at 3 years followup.

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“…Diese Medikamente sollten daher bei Patienten mit schwereren Formen einer Dolichoektasie vorsichtig angewendet werden [81,82]. [72,83,84], die inzwischen zu einer sicheren und hochwirksamen chirurgischen Technik zur Linderung einfacher neurovaskulärer Kompressionssyndrome geworden ist. Bei dieser Technik wird üblicherweise zwischen dem pathologischen Gefäß und dem Nerv ein Polster aus Polytetrafluorethylen oder ein anderes synthetisches Implantat eingebracht [72].…”

Section: Behandlungunclassified

Multimodale Bildgebung der vertebrobasilären Dolichoektasie

Samim¹,

Goldstein²,

Schindler³

et al. 2018

Neuroradiol Scan

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Vertebrobasilar dolichoectasia (VBD) is characterized by ectasia, elongation, and tortuosity of the vertebrobasilar arteries, with a high degree of variability in clinical presentation. The disease origin is believed to involve degeneration of the internal elastic lamina, thinning of the media secondary to reticular fiber deficiency, and smooth muscle atrophy. The prevalence of VBD is variable, ranging from 0.05?% to 18?%. Most patients with VBD are asymptomatic and their VBD is detected incidentally; however, it is important to recognize that the presence of symptoms, which can lead to clinically significant morbidity and sometimes mortality, may influence clinical management. The most important clinical presentations of VBD are vascular events, such as ischemic stroke and catastrophic intracranial hemorrhage, or progressive compressive symptoms related to compression of adjacent structures, including the cranial nerves, brainstem, or third ventricle, causing hydrocephalus. The imaging diagnostic criteria for computed tomography and magnetic resonance (MR) imaging include three quantitative measures of basilar artery morphology: laterality score, height of bifurcation, and basilar artery diameter. The authors review the relevant anatomy and disease origin of VBD; pertinent imaging findings, including intraluminal thrombus and relation to the cranial nerves; and imaging pitfalls, such as the hyperintense vessel sign on MR images and artifacts related to slow flow in the dolichoectatic vessel. In addition, clinical manifestations, the role of radiology in diagnosis and management of this condition, and available management options are reviewed.

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Vertebrobasilar dolichoectasia as a cause of trigeminal neuralgia: the role of microvascular decompression. Case report

Cited by 23 publications

References 25 publications

Vertebrobasilar artery dolichoectesia and pain; coincidence or etiology ?

Vertebrobasilar artery dolichoectesia and pain; coincidence or etiology ?

Recurrent Piriformis Syndrome After Surgical Release

Multimodale Bildgebung der vertebrobasilären Dolichoektasie

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