Abstract
Microvascular decompression (MVD) is now a standard treatment for trigeminal neuralgia
(tic douloureux). The goal of MVD is to decompress the trigeminal root from offending
vessels, aiming at a permanent cure with no or little sensory deficit. Preoperative
identification of neurovascular compression, therefore, has potentially important
implications for patient selection, surgical planning, and outcomes. In this study,
enhanced three-dimensional fast spoiled gradient recalled MRI and three-dimensional
magnetic resonance angiography with a 3.0-Tesla MRI system were used to detect the
anatomic relationship of neural and vascular structures at the trigeminal root entry
zone (TREZ) preoperatively. In 27 of 29 patients (93%), surgical findings were consistent
with the imaging results. All patients treated with MVD achieved complete pain relief.
The usefulness of high-resolution MRI in revealing the neurovascular contact at the
TREZ was demonstrated, and it could be used to facilitate the selection of treatment
modality. Thus, MVD can be chosen for patients who are most likely to benefit from
this intracranial procedure.
Keywords
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Article info
Publication history
Accepted:
February 17,
2009
Received:
March 30,
2008
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
