Anatomoclinical features of trigeminal neuralgia caused by vertebrobasilar dolichoectasia

• Autores: Fernando Ruiz Juretschke, Begoña Iza Vallejo, Eva Maranillo Alcaide
• Localización: European Journal of anatomy, ISSN-e 1136-4890, Vol. 20, Nº. 2, 2016, págs. 185-190
• Idioma: inglés
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• Resumen

  • Vertebrobasilardolichoectasia (VBDE) is a rare cause of trigeminal neuralgia (TN). The size and tortuous course of the offending vessel poses a particular challenge when attempting a surgical treatment with microvascular decompression. There are few reports on the radiological and surgical anatomy encountered in this condition. The anatomical and radiological features of a surgical series of 7 patients with TN caused by VBDE and treated with microvascular decompression (MVD) are presented. Morphometric measurements and three-dimensional reconstructions obtained from preoperative magnetic resonance imaging were compared with microsurgical findings. Trigeminal nerve compression was found on the left side in six cases (86%). The neurovascular compression was caused by the basilar artery (BA) in 4 cases and the vertebral artery (VA) in three cases, with two cases showing a multiple compression involving other vessels. The BA showed a mean maximal diameter of 6,5 mm (5-9,1 mm), a mean lateral deviation of 19,3 mm (14,4- 22,1 mm) and a mean elevation of the basilar tip above the dorsum sellae of 10,5 mm (4,4-14,8 mm). MVD was successfully performed in all patients yielding a permanent pain relief in six of the patients. Preoperative assessment of the neurovascular relations within the cerebello-pontine angle is paramount for the surgical planning in patients with TN caused by VBDE.