VNS implantation in a NF1 patient: massive nerve hypertrophy discovered intra-operatively preventing successful electrode placement. Case report

Hamdi, Hussein; Brun, Gilles; Zanello, Marc; Dibué, Maxine; Beltaifa, Y.; Lagarde, Stanislas; Trébuchon, Agnès; Bartolomei, Fabricē; Carron, Romain

doi:10.1007/s00701-020-04535-y

Cited by 1 publication

(1 citation statement)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, this technique provides us the precise information about the anatomical vagus nerve, IJV, and CCA location at the skin incision level. Apart from anatomical variations of the vagus nerve, a previous study reported the case, in which the VNS electrodes were placed on the hypertrophic vagus nerve in a neurofibromatosis type 1 (NF1) patient [ 8 ]. Therefore, the vagus nerve visualization prior to VNS might be strongly recommended in cases of NF1 patients.…”

Section: Discussionmentioning

confidence: 99%

Vagus Nerve Visualization Using Fused Images of 3D-CT Angiography and MRI as Preoperative Evaluation for Vagus Nerve Stimulation

et al. 2023

View full text Add to dashboard Cite

Vagus nerve stimulation (VNS) is an effective surgical option for intractable epilepsy. Although the surgical procedure is not so complicated, vagus nerve detection is sometimes difficult due to its anatomical variations, which may lead to surgical manipulation-associated complications. Thus, this study aimed to visualize the vagus nerve location preoperatively by fused images of three-dimensional computed tomography angiography (3D-CTA) and magnetic resonance imaging (MRI). This technique was applied to two cases. The neck 3D-CTA and MRI were performed, and the fused images were generated using the software. The vagus nerve and its anatomical relationship with the internal jugular vein (IJV) and common carotid artery were clearly visualized. The authors predicted that the vagus nerve was detected by laterally pulling the IJV according to the images. Intraoperatively, the vagus nerve was located as the authors predicted. The time of the surgery until the vagus nerve detection was <60 min in both cases. This novel radiological technique for visualizing the vagus nerve is effective to quickly detect the vagus nerve, which has anatomical variations, during the VNS.

show abstract

Section: Discussionmentioning

confidence: 99%