Hydrocephalus: an underrated long-term complication of microvascular decompression for trigeminal neuralgia. A single institute experience

Perioperative Nursing Care of Vascular Decompression for Trigeminal Neuralgia under AR Medical Technology

AR technology, also known as AR or virtual reality, refers to a technology that combines and allows interaction of the virtual world on the display system with the real world through the position and angle of the camera video and image analysis technology. This technology is different from VR technology, and its characteristics can be easily explained as follows: when using AR technology, the user's eyes can see not only the real world but also the virtual world derived from the computer through things in the real world. At present, AR has been widely used in education, engineering, entertainment, and medical fields. In order to provide better perioperative care and bring patients a good nursing experience, this article mainly introduces the perioperative care of vascular decompression in the treatment of trigeminal neuralgia by augmented reality medical technology, in order to provide better care for patients with trigeminal neuralgia. This article proposes the perioperative nursing research method of vascular decompression for the treatment of trigeminal neuralgia under AR medical technology, including an overview of trigeminal neuralgia, perioperative related research, and AR medical technology algorithms, and designs related experiments to study whether AR medical technology can bring good news to nursing. Experimental results show that 96% of patients believe that with the enhancement of realistic medical technology, perioperative vascular decompression care for trigeminal neuralgia can help them recover faster and can be gradually popularized.

Two times of trigeminal neuralgia resolution following hydrocephalus treatment in a patient with a high-voltage electric shock to his head: a case report and a review of the literature

Hydrocephalus has rarely been reported to be associated with trigeminal neuralgia. Here we report for the first time a case of trigeminal neuralgia associated with hydrocephalus, whose symptoms completely resolved twice after ventriculoperitoneal shunting. The patient had a high-voltage electric shock to his head, which has not been reported in a patient with ventriculoperitoneal shunt to the best of our knowledge. The possible underlying mechanism of this situation is discussed in addition to a brief review of the literature.

Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.