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Cheng S, Zhang Y, Ou C, Li F. Postherpetic Trigeminal Neuralgia of the V2 Branch Treated with Electrodes Placed through the Foramen Ovale: A Case Report. J Neurol Surg A Cent Eur Neurosurg 2024; 85:427-430. [PMID: 36914155 DOI: 10.1055/a-2053-3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Varicella-zoster virus (VZV) is a deoxyribonucleic acid (DNA) virus that causes both primary and recurrent viral infections. Herpes zoster (HZ), also known as shingles, is a unique condition that is induced by VZV reactivation. Neuropathic pain, malaise, and sleep disruption are prodromal symptoms in such cases. Postherpetic trigeminal neuralgia is a neuropathic pain caused by VZV infection of the trigeminal ganglion or branches, which remains or reappears after herpes crusting. In this report, we present a case of post-herpetic trigeminal neuralgia of the V2 branch, exhibiting findings of unusual involvement of the trigeminal nerve. Notably, the patient was treated using electrodes placed through the foramen ovale.
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Affiliation(s)
- Sitong Cheng
- Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yue Zhang
- Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Cehua Ou
- Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fubo Li
- Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou, China
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Xi L, Liu X, Shi H, Han W, Gao L, Wang L, Liu J, Ren Y, Du Y, Liu G. Comparative safety and efficacy of percutaneous radiofrequency thermocoagulation and percutaneous balloon compression in CT-guided and local anesthesia for recurrent trigeminal neuralgia. Front Neurol 2024; 14:1336261. [PMID: 38249730 PMCID: PMC10797886 DOI: 10.3389/fneur.2023.1336261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are several ways to treat trigeminal neuralgia (TN); however, TN may recur after treatment. Although microvascular decompression (MVD) is considered an effective treatment for trigeminal neuralgia, patients with recurrence may not be willing to undergo craniotomy. Objective This study compared the safety and efficacy of percutaneous radiofrequency thermocoagulation and percutaneous balloon compression for treating recurrent trigeminal neuralgia. Methods This was a prospective non-randomized controlled study. A total of 52 with recurrent TN were scheduled to undergo surgery in our Hospital from January-June 2021. The patients were classified into percutaneous radiofrequency thermocoagulation (PRT) and percutaneous balloon compression (PBC) groups based on the treatment. All surgeries were performed under computed tomography guidance and local anesthesia. Post-operative complications were also observed. Pain was assessed using the visual analog scale (VAS) and Barrow Neurological Institute (BNI) scale. Efficacy indices were evaluated at 3, 6, 12, and 18 months after surgery. Results During follow-up, the efficacy rates of the two methods within 18 months were 76.0 and 88.9%, respectively. All patients had hypoesthesia on the affected side, and no severe complications. Notably, 5 patients (20%) in the PRT group with multiple-branch pain, including the first branch of the trigeminal nerve (V1) pain in the PRT group, received radiofrequency therapy for the supraorbital notch (foramen) after puncture of the foramen ovale. However, multiple pain episodes resolved with only one operation in the PBC group. Conclusion CT-guided percutaneous radiofrequency thermocoagulation and percutaneous balloon compression under local anesthesia may be good options for treating recurrent trigeminal neuralgia. Percutaneous balloon compression may be recommended when multiple branches are involved, particularly in cases of V1 neuralgia.
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Affiliation(s)
- Lulu Xi
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xiaohui Liu
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hongchen Shi
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Wenbiao Han
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Liqin Gao
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Wang
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Junpeng Liu
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yue Ren
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuanyuan Du
- Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Guangzhao Liu
- Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Chen LP, Li D, Li XJ, Song LR, Zhang LW, Wu Z, Zhang JT, Wang L. Postoperative trigeminal neuropathy outcomes following surgery for tumors involving the trigeminal nerve. Acta Neurochir (Wien) 2023; 165:2885-2893. [PMID: 37581723 DOI: 10.1007/s00701-023-05735-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE To observe the evolution and outcomes of postoperative trigeminal neuropathy following surgery of tumor involving the trigeminal nerve. METHODS A prospective observational study was conducted between October 2018 and February 2019 involving 25 patients with tumors confirmed to involve the trigeminal nerve during surgery by senior author. Pre- and postoperative trigeminal nerve function status and clinical data were recorded. RESULTS This study included 18 cases of meningioma and seven of trigeminal schwannoma. Among the meningioma cases, 55.6% of the patients reported facial sensory dysfunction before surgery, 33.3% presented ocular discomfort, and 5.6% had masticatory muscle atrophy. Postoperatively, all patients experienced facial paresthesia, 94.4% complained of eye dryness, and one (5.56%) exhibited keratitis. Additionally, one patient (5.56%) showed new-onset masticatory weakness. During follow-up, 50.0% of patients reported improvement in facial paresthesia, and one (5.56%) experienced deterioration. Eye dryness resolved in 35.3% of patients, and keratitis remission was observed in one patient. However, one patient (5.56%) developed neurotrophic keratitis. Overall, 55.6% of patients displayed mild masticatory weakness without muscle atrophy. In the cases of schwannoma, 28.6% of patients had facial paresthesia before surgery, 42.9% showed ocular discomfort, and one (14.3%) complained of masticatory dysfunction. Postoperatively, 85.7% of patients reported facial paresthesia and eye dryness, with one patient (16.7%) experiencing keratitis. During follow-up, 66.7% of patients demonstrated improvement in facial paresthesia, 28.6% showed eye dryness remission, and one patient (16.7%) recovered from keratitis. However, one patient (16.7%) developed new-onset neurotrophic keratitis. One patient (16.7%) experienced relief of masticatory dysfunction, but 42.9% reported mild deterioration. Another patient (14.3%) had facial anesthesia that had not improved. CONCLUSION Postoperative trigeminal neuropathy is a common complication with a high incidence rate and poor recovery outcomes after surgery for tumors involving the trigeminal nerve. When trigeminal nerve damage is unavoidable, it is essential to provide a multidisciplinary and careful follow-up, along with active management strategy, to mitigate the more severe effects of postoperative trigeminal neuropathy.
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Affiliation(s)
- Liang-Peng Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China
| | - Da Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China
| | - Xiao-Jie Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China
| | - Lai-Rong Song
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China
| | - Li-Wei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China
| | - Jun-Ting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China.
| | - Liang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Beijing Key Laboratory of Brain Tumor, National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, 100070, China.
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Zheng W, Wang L, Wang H, Zhou H, Du Q. Trigeminal neuralgia caused by vertebrobasilar dolichoectasia: efficacy of stepwise decompression technique. Acta Neurochir (Wien) 2023; 165:3019-3026. [PMID: 37353618 DOI: 10.1007/s00701-023-05691-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To explore and analyze the clinical efficacy of a stepwise decompression technique in the treatment of trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia (VBD). METHODS A total of 918 patients with TN admitted to our hospital from June 2015 to May 2020 were divided into the VBD group (n = 61) and the conventional group (n = 857). The VBD group underwent stepwise decompression, while the conventional group received traditional microvascular decompression (MVD) surgery. Patients associated with the VBD were divided into direct compression (n = 14) and indirect compression group (n = 47) who had compression by other vessels in the presence of the VBD. Thereafter, the clinical data, intraoperative findings, efficacy, and complications were analyzed. RESULTS The curative ratio, efficacy, and recurrence rate for the VBD and conventional group were 83.6% and 89.6%, 93.4% and 95.3%, and 8.2% and 5.3%, respectively. The curative ratio, efficacy, and recurrence rate for the direct compression and indirect compression group were 85.7% and 83.0%, 92.9% and 93.6%, and 7.1% and 8.5%, separately. There were no significant differences in the curative ratio, efficacy, recurrence rate, and the incidence of complications between the two series (P > 0.05). CONCLUSION For TN caused by VBD, stepwise decompression not only reduces the direct compression of the trigeminal nerve by VBA but also allows identification and decompression of the actual vessels responsible for the compression. It has a good curative ratio, efficacy, and long-term pain relief rate, and it does not significantly increase the incidences of complications after surgery.
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Affiliation(s)
- Wenhao Zheng
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Linjie Wang
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Heng Wang
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Haotian Zhou
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Quan Du
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Tan K, Li J, Peng Y, Wu W, Yang Z, Wang Y, Wang Y. Robot-Assisted Percutaneous Balloon Compression in Elderly Patients with Trigeminal Neuralgia. J Pain Res 2023; 16:1161-1168. [PMID: 37051267 PMCID: PMC10084829 DOI: 10.2147/jpr.s396680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Objective To investigate the clinical effects of percutaneous balloon compression (PBC) for trigeminal neuralgia in elderly patients with the assistance of a neurosurgical navigation and positioning planning system (referred to hereafter as the robot). Methods We performed a retrospective analysis of 11 patients with trigeminal neuralgia. Preoperative TOF MRA, T2WI-SPACE, and thin-slice CT scans were performed, and the volume of Meckel's Cave was calculated by multi-modal image fusion on a workstation. Surgical planning involved two paths. Path A was the actual puncture path, the target point was the anterior inner quadrant of the inner opening of the foramen ovale; Path B represented a virtual path for measurement, and was used to plan the depth of balloon placement. The foramen ovale puncture for path A was completed under the guidance of a robotic arm adapter, while path B was completed under lateral X-ray fluoroscopy with a DSA machine. The balloon was placed at a predetermined depth, and filled to a "pear" shape to complete the operation. Preliminary follow-up results were obtained by considering VAS score and BNI classification. Results The foramen ovale was successfully punctured in all 11 patients and entered Meckel's Cave, the balloon was then filled to create a "pear shape". Immediate complete healing was achieved in 10 patients and delayed healing was achieved in one patient by the 5th postoperative day. No serious complications were identified that were related to surgery, and over a follow-up time of 1-12 months, there was no recurrence of pain, and a BNI numbness grade of 2-3 points. The appropriate ratio of the balloon inflated volume to the preoperative Meckel's Cave volume was approximately 1.7. Conclusion Preliminary clinical application and short-term follow-up showed that robot-assisted PBC surgery is a safe and effective surgical method for elderly patients with trigeminal neuralgia.
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Affiliation(s)
- Ke Tan
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
- Correspondence: Ke Tan, Email
| | - Jinping Li
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Yutao Peng
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Wenqian Wu
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Ziwen Yang
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Yu Wang
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Yang Wang
- Department of Neurosurgery, BeiJing ChaoYang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
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Xia Y, Yu G, Min F, Xiang H, Huang J, Leng J. The Focus and New Progress of Percutaneous Balloon Compression for the Treatment of Trigeminal Neuralgia. J Pain Res 2022; 15:3059-3068. [PMID: 36199499 PMCID: PMC9529012 DOI: 10.2147/jpr.s374433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Trigeminal neuralgia is a condition confined to the trigeminal nerve, causing one or more branches of facial nerve pain. Surgical treatment options for trigeminal neuralgia include microvascular decompression(MVD), percutaneous balloon compression (PBC), radiofrequency thermocoagulation(RF), percutaneous retrogasserian glycerol rhizotomy(PRGR), gamma knife, etc. Of these treatments, PBC is increasingly being used by clinicians for trigeminal neuralgia. PBC is a simple surgical operation performed to treat trigeminal neuralgia. Owing to its advantages, PBC is favored by many clinicians. In this study, we aimed to emphasize the need to analyze the shape of the balloon, position, compression time, and pressure, as these factors can affect the efficacy of PBC. The relief of pain by balloon compression is related to the shape of the balloon on X-ray, which is the key to the operation. Owing to continued progress and advances in current imaging technologies, clinicians revealed that the precise positioning of the foramen ovale is no longer an intraoperative problem. Instead, the anatomy of Meckel’s cave and the shape of the balloon must be the focus to achieve the best treatment effect. For clinicians, PBC is simple and is associated with a short operation time. PBC also has other advantages, such as low cost and immediate postoperative pain relief. The recurrence rate of pain post-PBC is low, despite the occurrence of facial numbness post-op. However, this side effect is reversible and does not affect daily life of the patient. In fact, the patient can be discharged 1–2 days after surgery. Overall, PBC can be considered as one of the preferred surgical methods for the treatment of primary trigeminal neuralgia. In this paper, we explain the main points of PBC operation in detail in terms of Meckel’s cave, surgical procedure, complications, discussion of the focus and new progress, etc.
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Affiliation(s)
- Yinghua Xia
- Medical College of Nanchang University, Nanchang, People’s Republic of China
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
| | - Gui Yu
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
- The First Clinical Medical College of Gannan Medical University, Ganzhou, People’s Republic of China
| | - Feixiang Min
- Medical College of Nanchang University, Nanchang, People’s Republic of China
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
| | - Hui Xiang
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
- Correspondence: Hui Xiang, Jiangxi Provincial People’s Hospital, No. 266, Fenghe North Avenue, Honggutan District, Nanchang City, People’s Republic of China, Tel +86-13803514563, Email
| | - Jinqing Huang
- Department of Neurosurgery, Ganzhou People’s Hospital, Ganzhou, People’s Republic of China
- Department of Neurosurgery, the Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, People’s Republic of China
- Jinqing Huang, Ganzhou People’s Hospital, No. 16, Meiguan Avenue, Zhanggong District, Ganzhou City, People’s Republic of China, Tel +86-18160779765, Email
| | - Jingxing Leng
- Department of Neurosurgery, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China
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Kikuchi A, Ishizaki S, Yokosako S, Kasuya H, Kubota Y. Clinical features of herpes simplex virus reactivation after microvascular decompression for trigeminal neuralgia: Experience of 200 patients and a literature review. Surg Neurol Int 2022; 13:371. [PMID: 36128128 PMCID: PMC9479613 DOI: 10.25259/sni_544_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Herpes simplex virus (HSV) reactivation occasionally develops in the early postoperative period after microvascular decompression (MVD) for trigeminal neuralgia (TN). Therefore, the present study investigated the clinical features of this phenomenon. Methods: The study cohort comprised 200 patients with 125 women aged between 17 and 90 years (median age, 66 years) who underwent MVD for TN between January 2010 and December 2020. Characteristics were compared between patients with and without HSV reactivation and clinical features were analyzed. Results: Twenty patients had HSV reactivation: herpes labialis in 18 and herpes zoster (final diagnosis) in 2. A multivariate analysis revealed independent correlations between postoperative HV reactivation and a previous history of herpes labialis (odds ratios [OR]: 6.32, P = 0.0003) and reoperation for recurrent or persistent pain (OR: 5.06, P = 0.0211). No significant differences were observed in pain relief, postoperative facial numbness, or Barrow Neurological Institute Pain Intensity/Facial Numbness Scores in the past follow-up between patients with and without HSV reactivation. HSV reactivation manifested at a median of the 4th postoperative day (1–10 days) and its location was not related to the preoperative distribution of facial pain. All patients were treated with local acyclovir and were completely cured within 1–2 weeks. Conclusion: HSV reactivation occurred in 10% of patients after MVD including 1% of herpes zoster. A previous history of herpes labialis and reoperation was identified as risk factors for reactivation. Symptoms were completely cured by antiviral drugs within 1–2 weeks. It is important to note that cases of herpes zoster may be confused with cases of HSV after MVD.
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Affiliation(s)
- Asami Kikuchi
- Department of Neurosurgery, Tokyo Women’s Medical University Adachi Medical Center,
| | - Sumiko Ishizaki
- Department of Dermatology, Tokyo Women’s Medical University Adachi Medical Center,
| | - Suguru Yokosako
- Department of Neurosurgery, Tokyo Women’s Medical University Adachi Medical Center,
| | | | - Yuichi Kubota
- Department of Neurosurgery, Tokyo Women’s Medical University Adachi Medical Center,
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Neth BJ, Cohen Cohen S, Trejo-Lopez J, Brinjikji W, Braksick SA, Fugate JE, Rabinstein AA, Wijdicks EFM. Mycotic aneurysm. Pract Neurol 2022; 22:407-409. [PMID: 35470248 DOI: 10.1136/practneurol-2021-003260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/03/2022]
Abstract
Angioinvasive fungal infections of the cerebral vasculature often lead to significant morbidity and mortality. High clinical suspicion and early antifungal therapy could improve outcomes. We describe the fatal case of a patient with a rapidly enlarging cavernous carotid aneurysm due to angioinvasive fungus. This case highlights the challenges in diagnosis and management of this condition.
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Affiliation(s)
- Bryan J Neth
- Mayo Clinic Rochester, Rochester, Minnesota, USA
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Zhen X, Xu X, Shao X, Tian H, Xu J, Zhu B, Zuo Y, Zhang L, Yu Y. Risk factors of herpes simplex virus reactivation after surgery for primary trigeminal neuralgia. J Neurovirol 2022; 28:367-373. [PMID: 35334082 DOI: 10.1007/s13365-022-01064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/20/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
The objective of this study is to investigate the risk factors of oral or facial herpes simplex virus (HSV-1) infection after primary trigeminal neuralgia (PTN). The clinical data of 33 PTN patients admitted by the same surgeon in the neurosurgery were retrospectively analyzed. Among the 33 patients, 26 patients underwent microvascular decompression (MVD), 6 patients who have not been found the clear offending vessels during the operation underwent partial sensory rhizotomy (PSR), and only one underwent adhesive band separation. Thirteen patients with postoperative oral and facial HSV-1 infection were selected as the herpes group, and the remaining 20 patients without postoperative oral and facial HSV-1 infection were selected as the non-herpes group. The differences between the two groups were compared by statistical analysis of factors such as gender, age, operation mode, operation time, and serum HSV-1 antibody titer value before surgery. Compared with the non-herpes group, there were no statistically significant differences in sex ratio (P = 0.930), age composition (P = 0.261), or disease profile (P = 0.226). Twenty-six patients underwent MVD operation, eight of whom were infected, and the difference between the two groups was statistically significant (P = 0.029). The operation time of the herpes group was 10-30 min, which was significantly longer than that of the non-herpes group. The difference in operation time between the two groups was statistically significant (P = 0.023). Serum HSV-1-IgM was negative (< 0.9 COI) in all patients before surgery, but the positive rate of HSV-1-IgG (≥ 1.1 COI) was 97%, and the titer was greater than four times in 97% (32/33) of patients. The titer of IgG antibody in the herpes group was significantly lower than that in the non-herpes group, and the difference between the two groups was statistically significant (P = 0.017). The serum HSV-1-IgG in most of the PTN patients was positive. Latent HSV-1 in the trigeminal ganglion may be reactivate after PTN surgery to produce ipsilateral oral and facial herpes infection. The infection of HSV-1 reactivation after PTN surgery was positively correlated with the operation time but negatively correlated with the titer of HSV-1-IgG antibody before PTN surgery. The incidence of HSV-1 infection after PTN operation is related to different surgical procedures.
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Affiliation(s)
- Xueke Zhen
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Xiaoli Xu
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Xu Shao
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Hong Tian
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Jun Xu
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Bin Zhu
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Ying Zuo
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Li Zhang
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China
| | - Yanbing Yu
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2 East Cherry Street, Chaoyang District, Beijing, 100029, China.
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Fan X, Fu Z, Ma K, Tao W, Huang B, Guo G, Huang D, Liu G, Song W, Song T, Xiao L, Xia L, Liu Y. Chinese expert consensus on minimally invasive interventional treatment of trigeminal neuralgia. Front Mol Neurosci 2022; 15:953765. [PMID: 35966020 PMCID: PMC9368781 DOI: 10.3389/fnmol.2022.953765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Trigeminal neuralgia is a common condition that is associated with severe pain, which seriously affects the quality of life of patients. When the efficacy of drugs is not satisfactory or adverse drug reactions cannot be tolerated, minimally invasive interventional therapy has become an important treatment because of its simple operation, low risk, high repeatability and low cost. In recent years, minimally invasive interventional treatments, such as radiofrequency thermocoagulation (RF) of the trigeminal nerve and percutaneous microcompression (PMC), have been widely used in the clinic to relieve severe pain in many patients, however, some related problems remain to be addressed. The Pain Association of the Chinese Medical Association organizes and compiles the consensus of Chinese experts to standardize the development of minimally invasive interventional treatment of trigeminal neuralgia to provide a basis for its clinical promotion and application. MATERIALS AND METHODS The Pain Association of the Chinese Medical Association organizes the Chinese experts to compile a consensus. With reference to the evidence-based medicine (OCEBM) system and the actual situation of the profession, the Consensus Development Committee adopts the nominal group method to adjust the recommended level. RESULTS Precise imaging positioning and guidance are the keys to ensuring the efficacy and safety of the procedures. RF and PMC are the most widely performed and effective treatments among minimally invasive interventional treatments for trigeminal neuralgia. CONCLUSIONS The pain degree of trigeminal neuralgia is severe, and a variety of minimally invasive intervention methods can effectively improve symptoms. Radiofrequency and percutaneous microcompression may be the first choice for minimally invasive interventional therapy.
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Affiliation(s)
- Xiaochong Fan
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhijian Fu
- Department of Pain Medicine, Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, China
| | - Ke Ma
- Department of Pain Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Tao
- Department of Functional Neurosurgery, Shenzhen University General Hospital, Shenzhen, China
| | - Bing Huang
- Department of Pain Medicine, The Affliated Hospital of Jiaxing University, Jiaxing, China
| | - Gang Guo
- Department of Interventional Medicine, Lanzhou University First Hospital, Lanzhou, China
| | - Dong Huang
- Department of Pain Medicine, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guangzhao Liu
- Department of Pain Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wenge Song
- Department of Pain Medicine, Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, China
| | - Tao Song
- Department of Pain Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Lizu Xiao
- Department of Pain Medicine, The Union Shenzhen Hospital of Huazhong Science and Technology University, Shenzhen, China
| | - Lingjie Xia
- Department of Pain Medicine, Henan Provincial People’s Hospital, Zhengzhou, China
- *Correspondence: Lingjie Xia,
| | - Yanqing Liu
- Department of Pain Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yanqing Liu,
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11
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Lam BC, Saboo US, Kheirkhah A. Acute neurotrophic keratitis with trigeminal trophic syndrome after craniotomy. J AAPOS 2020; 24:376-379. [PMID: 33228954 DOI: 10.1016/j.jaapos.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 11/19/2022]
Abstract
We report the case of a child who, shortly after undergoing suboccipital craniotomy for resection of a medullary cavernoma, developed corneal and conjunctival epithelial breakdown of the right eye with ipsilateral facial hypoesthesia as well as erosions and crusting of the eyelids, nostril, and lips on the right side. This combination of findings likely results from acute injury to the ipsilateral trigeminal ganglion, leading to acute neurotrophic keratitis and trigeminal trophic syndrome.
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Affiliation(s)
- Brandon C Lam
- Department of Ophthalmology, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, Texas
| | - Ujwala Sachin Saboo
- Department of Ophthalmology, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, Texas
| | - Ahmad Kheirkhah
- Department of Ophthalmology, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, Texas.
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