Microvascular Decompression Surgery
Decompression, Surgical
Trigeminal Neuralgia
Hemifacial Spasm
Nerve Compression Syndromes
Glossopharyngeal Nerve Diseases
Trigeminal Nerve
Decompression
Laminectomy
Facial Nerve Diseases
Decompression Sickness
Graves Ophthalmopathy
Spasm
Lumbar Vertebrae
Glossopharyngeal Nerve
Treatment Outcome
Postoperative Complications
Magnetic Resonance Imaging
Retrospective Studies
Prospective Studies
Microvascular decompression: salient surgical principles and technical nuances. (1/11)
(+info)Identification of a persistent primitive trigeminal artery following the transposition technique for trigeminal neuralgia: a case report. (2/11)
A patient who presented with trigeminal neuralgia associated with a persistent primitive trigeminal artery (PPTA) is presented. A 62-year-old woman suffering from right orbital pain was admitted to the hospital. Medical treatment for three months was ineffective, and her neuralgia had deteriorated and gradually spread in the maxillary division. Magnetic resonance imaging demonstrated the flow void signal attached to the right trigeminal nerve. Thus, microvascular decompression was performed. The superior cerebellar artery was the responsible artery, and it was transposed to decompress the trigeminal nerve. After this manoeuvre, an artery was identified running parallel to the trigeminal nerve toward Meckel's cave. The artery, which turned out to be a PPTA, communicated with the basilar artery. The PPTA was carefully observed, and it was found not to be the artery causing the neuralgia because it did not compress the nerve at surgical observation. No additional procedure between the PPTA and the trigeminal nerve was performed. The patient's symptom improved dramatically following surgery, and her postoperative course was uneventful. Postoperative three-dimensional computed tomography showed the PPTA. The findings in the present case suggest that transposition of the responsible artery effectively decompresses the root entry zone and assists in determining whether the PPTA is affecting the trigeminal nerve. (+info)Vagoglossopharyngeal neuralgia treated by microvascular decompression and glossopharyngeal rhizotomy: clinical results of 21 cases. (3/11)
(+info)Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression. (4/11)
BACKGROUND: Microvascular decompression (MVD) is a well accepted surgical treatment strategy for trigeminal neuralgia (TN) with satisfying long-term outcome. However, considerable recurrent patients need more effective management. The purpose of this study was to evaluate the effectiveness of radiofrequency thermocoagulation rhizotomy (RTR) on patients with recurrent TN after MVD. METHODS: Totally 62 cases of recurrent TN after MVD undergoing RTR from January 2000 to January 2010 were retrospectively evaluated. Based on surgical procedures undertaken, these 62 cases were classified into two subgroups: group A consisted of 23 cases that underwent traditional RTR by free-hand; group B consisted of 39 cases that underwent RTR under the guidance of virtual reality imaging technique or neuronavigation system. The patients in group A were followed up for 14 to 70 months (mean, 40 +/- 4), and those in group B were followed up for 13 to 65 months (mean, 46 +/- 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups. RESULTS: All patients in both groups A and B attained immediate pain relief after RTR. Both groups attained good pain relief rate within the first two years of follow-up: 92.3%, 84.6% and 82.6%, 69.6% respectively (P > 0.05). After 2 years, the virtual reality or neuronavigation assisted RTR group (group B) demonstrated higher pain relief rates of 82.5%, 76.2% and 68.8% at 3, 4 and 5 years after operation respectively, while those in group A was 57.2%, 49.6%, and 36.4% (P < 0.05). Low levels of minor complications were recorded, while neither mortalities nor significant morbidity was documented. CONCLUSIONS: RTR was effective in alleviating the pain of TN cases suffering from unsuccessful MVD management. With the help of virtual reality imaging technique or neuronavigation system, the patients could attain better long-term pain relief. (+info)A comparison of three induction regimens using succinylcholine, vecuronium, or no muscle relaxant: impact on the intraoperative monitoring of the lateral spread response in hemifacial spasm surgery: study protocol for a randomised controlled trial. (5/11)
(+info)Microvascular decompression of cochleovestibular nerve in patients with tinnitus and vertigo. (6/11)
(+info)Hemifacial spasm: conservative and surgical treatment options. (7/11)
(+info)Recurrent trigeminal neuralgia at 20 years after surgery: case report. (8/11)
Microvascular decompression (MVD) is now the most feasible method of treatment for trigeminal neuralgia (TN). The recurrence of symptoms is rarely encountered postoperatively. A female patient with typical right V3 distribution TN had been successfully treated by MVD at age 56 years by transposing the offending superior cerebellar artery, and she became completely pain-free postoperatively without sequelae. Twenty years after the first MVD, pain recurred on the right V2 distribution at age 76 years and she was operated on a second time to resolve the pain. Re-exploration surgery revealed that the trigeminal nerve was compressed mediocranially by the anterior inferior and posterior inferior cerebellar artery complex, which had not been close to the neural structure during the first surgery. The artery complex was successfully transpositioned to decompress the root exit zone (REZ) of the nerve and she became pain-free again. Although various causal factors likely contribute to recurrence of TN, the present case of recompression of a REZ occurred due to a newly developed offending artery which caused TN a long time after the first surgery. (+info)Microvascular decompression surgery (MVD) is a surgical procedure used to alleviate the symptoms of certain neurological conditions, such as trigeminal neuralgia and hemifacial spasm. The primary goal of MVD is to relieve pressure on the affected cranial nerve by placing a small pad or sponge between the nerve and the blood vessel that is causing compression. This procedure is typically performed under a microscope, hence the term "microvascular."
During the surgery, the neurosurgeon makes an incision behind the ear and creates a small opening in the skull (a craniotomy) to access the brain. The surgeon then identifies the affected nerve and the blood vessel that is compressing it. Using specialized instruments under the microscope, the surgeon carefully separates the blood vessel from the nerve and places a tiny pad or sponge between them to prevent further compression.
The benefits of MVD include its high success rate in relieving symptoms, minimal impact on surrounding brain tissue, and lower risk of complications compared to other surgical options for treating these conditions. However, as with any surgery, there are potential risks and complications associated with MVD, including infection, bleeding, cerebrospinal fluid leakage, facial numbness, hearing loss, balance problems, and very rarely, stroke or death.
It is essential to consult a qualified neurosurgeon for a thorough evaluation and discussion of the risks and benefits of microvascular decompression surgery before making a treatment decision.
Surgical decompression is a medical procedure that involves relieving pressure on a nerve or tissue by creating additional space. This is typically accomplished through the removal of a portion of bone or other tissue that is causing the compression. The goal of surgical decompression is to alleviate symptoms such as pain, numbness, tingling, or weakness caused by the compression.
In the context of spinal disorders, surgical decompression is often used to treat conditions such as herniated discs, spinal stenosis, or bone spurs that are compressing nerves in the spine. The specific procedure used may vary depending on the location and severity of the compression, but common techniques include laminectomy, discectomy, and foraminotomy.
It's important to note that surgical decompression is a significant medical intervention that carries risks such as infection, bleeding, and injury to surrounding tissues. As with any surgery, it should be considered as a last resort after other conservative treatments have been tried and found to be ineffective. A thorough evaluation by a qualified medical professional is necessary to determine whether surgical decompression is appropriate in a given case.
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which is one of the largest nerves in the head. It carries sensations from the face to the brain.
Medically, trigeminal neuralgia is defined as a neuropathic disorder characterized by episodes of intense, stabbing, electric shock-like pain in the areas of the face supplied by the trigeminal nerve (the ophthalmic, maxillary, and mandibular divisions). The pain can be triggered by simple activities such as talking, eating, brushing teeth, or even touching the face lightly.
The condition is more common in women over 50, but it can occur at any age and in either gender. While the exact cause of trigeminal neuralgia is not always known, it can sometimes be related to pressure on the trigeminal nerve from a nearby blood vessel or other causes such as multiple sclerosis. Treatment typically involves medications, surgery, or a combination of both.
Hemifacial spasm is a neuromuscular disorder characterized by involuntary, irregular contractions or twitching of the muscles on one side of the face. These spasms typically begin around the eye and may progress to involve the muscles of the lower face, including those around the mouth.
The primary cause of hemifacial spasm is pressure on or irritation of the facial nerve (cranial nerve VII) as it exits the brainstem, often due to a blood vessel or tumor. This pressure can lead to abnormal electrical signals in the facial nerve, resulting in uncontrolled muscle contractions.
In some cases, hemifacial spasm may be associated with other conditions such as multiple sclerosis or Bell's palsy. Treatment options for hemifacial spasm include medications to help relax the muscles, botulinum toxin (Botox) injections to paralyze the affected muscles temporarily, and, in rare cases, surgical intervention to relieve pressure on the facial nerve.
Nerve compression syndromes refer to a group of conditions characterized by the pressure or irritation of a peripheral nerve, causing various symptoms such as pain, numbness, tingling, and weakness in the affected area. This compression can occur due to several reasons, including injury, repetitive motion, bone spurs, tumors, or swelling. Common examples of nerve compression syndromes include carpal tunnel syndrome, cubital tunnel syndrome, radial nerve compression, and ulnar nerve entrapment at the wrist or elbow. Treatment options may include physical therapy, splinting, medications, injections, or surgery, depending on the severity and underlying cause of the condition.
Microsurgery is a surgical technique that requires the use of an operating microscope and fine instruments to perform precise surgical manipulations. It is commonly used in various fields such as ophthalmology, neurosurgery, orthopedic surgery, and plastic and reconstructive surgery. The magnification provided by the microscope allows surgeons to work on small structures like nerves, blood vessels, and tiny bones. Some of the most common procedures that fall under microsurgery include nerve repair, replantation of amputated parts, and various types of reconstructions such as free tissue transfer for cancer reconstruction or coverage of large wounds.
The glossopharyngeal nerve, also known as the ninth cranial nerve (CN IX), is primarily responsible for providing motor innervation to the stylopharyngeus muscle and sensory innervation to parts of the pharynx, middle ear, and posterior tongue. It also plays a role in the reflexive control of heart rate via the baroreceptors located in the carotid sinus.
Glossopharyngeal nerve diseases refer to conditions that affect the function of this nerve, leading to various symptoms. These diseases can be classified into two main categories: peripheral and central. Peripheral disorders are caused by damage or injury to the nerve itself, while central disorders result from problems in the brainstem where the glossopharyngeal nerve originates.
Some examples of glossopharyngeal nerve diseases include:
1. Glossopharyngeal neuralgia: A rare condition characterized by severe, stabbing pain in the throat, ear, or tongue, often triggered by swallowing or talking. This disorder may be caused by compression of the nerve by blood vessels or other structures.
2. Infections: Bacterial and viral infections can cause inflammation and damage to the glossopharyngeal nerve, leading to dysfunction. Examples include Lyme disease, herpes zoster (shingles), and meningitis.
3. Tumors: Benign or malignant growths in the head and neck region can compress and injure the glossopharyngeal nerve, resulting in symptoms related to its dysfunction.
4. Trauma: Direct trauma to the neck or skull base can damage the glossopharyngeal nerve, causing various deficits depending on the severity of the injury.
5. Neurological disorders: Conditions such as multiple sclerosis and stroke can affect the central connections of the glossopharyngeal nerve in the brainstem, leading to dysfunction.
6. Genetic conditions: Rare genetic disorders like Moersch-Woltman syndrome (also known as stiff person syndrome) can involve the glossopharyngeal nerve and cause symptoms related to its dysfunction.
Symptoms of glossopharyngeal nerve dysfunction may include difficulty swallowing, hoarseness, loss of taste on the back of the tongue, decreased sensation in the throat or ear, and pain in the neck, throat, or ear. Treatment for these conditions depends on the underlying cause and may involve medications, surgery, or other interventions to address the specific problem.
Spinal stenosis is a narrowing of the spinal canal or the neural foramina (the openings through which nerves exit the spinal column), typically in the lower back (lumbar) or neck (cervical) regions. This can put pressure on the spinal cord and/or nerve roots, causing pain, numbness, tingling, or weakness in the affected areas, often in the legs, arms, or hands. It's most commonly caused by age-related wear and tear, but can also be due to degenerative changes, herniated discs, tumors, or spinal injuries.
The trigeminal nerve, also known as the fifth cranial nerve or CNV, is a paired nerve that carries both sensory and motor information. It has three major branches: ophthalmic (V1), maxillary (V2), and mandibular (V3). The ophthalmic branch provides sensation to the forehead, eyes, and upper portion of the nose; the maxillary branch supplies sensation to the lower eyelid, cheek, nasal cavity, and upper lip; and the mandibular branch is responsible for sensation in the lower lip, chin, and parts of the oral cavity, as well as motor function to the muscles involved in chewing. The trigeminal nerve plays a crucial role in sensations of touch, pain, temperature, and pressure in the face and mouth, and it also contributes to biting, chewing, and swallowing functions.
Rhizotomy is a surgical procedure where the root(s) of a nerve are cut. It is often used to treat chronic pain, spasticity, or other neurological symptoms that have not responded to other treatments. In some cases, only a portion of the nerve root may be severed (selective rhizotomy), while in others the entire root may be cut (root transaction). The specific nerves targeted during a rhizotomy depend on the individual patient's condition and symptoms.
This procedure is typically performed by a neurosurgeon, and it can be done through an open surgical approach or using minimally invasive techniques such as endoscopic or percutaneous approaches. After the surgery, patients may require physical therapy to help regain strength and mobility in the affected area. Potential risks of rhizotomy include numbness, weakness, and loss of reflexes in the areas served by the severed nerves.
Decompression, in the medical context, refers to the process of reducing pressure on a body part or on a tissue, organ, or fluid within the body. This is often used to describe procedures that are intended to relieve excessive pressure built up inside the body, such as:
1. Decompression sickness treatment: Also known as "the bends," this condition occurs when nitrogen bubbles form in the blood and tissues due to rapid decompression, typically during scuba diving. Decompression involves using a hyperbaric chamber to slowly reduce the pressure and allow the nitrogen to safely dissolve and be eliminated from the body.
2. Spinal decompression: This is a minimally invasive therapeutic treatment for managing pain in the spine, often used to alleviate pressure on nerves or discs within the spinal column. Decompression can be achieved through various methods, such as traction, motorized tables, or vacuum-created devices that gently stretch and realign the spine, promoting circulation and reducing pressure on compressed nerves.
3. Ear decompression: This procedure is used to equalize pressure in the middle ear during scuba diving or flying at high altitudes. It can be achieved by swallowing, yawning, or performing the Valsalva maneuver (pinching the nose and blowing gently). In some cases, a doctor may need to perform a myringotomy, which involves making a small incision in the eardrum to relieve pressure.
4. Decompression of body parts: This can be relevant in situations where a part of the body is subjected to increased pressure due to various reasons, such as compartment syndrome or edema. In these cases, decompression may involve surgical intervention to release the pressure and prevent further damage to tissues and nerves.
Please note that this list is not exhaustive, and there might be other medical scenarios where the term "decompression" is used in a similar context.
A laminectomy is a surgical procedure that involves the removal of the lamina, which is the back part of the vertebra that covers the spinal canal. This procedure is often performed to relieve pressure on the spinal cord or nerves caused by conditions such as herniated discs, spinal stenosis, or tumors. By removing the lamina, the surgeon can access the affected area and alleviate the compression on the spinal cord or nerves, thereby reducing pain, numbness, or weakness in the back, legs, or arms.
Laminectomy may be performed as a standalone procedure or in combination with other surgical techniques such as discectomy, foraminotomy, or spinal fusion. The specific approach and extent of the surgery will depend on the patient's individual condition and symptoms.
Facial nerve diseases refer to a group of medical conditions that affect the function of the facial nerve, also known as the seventh cranial nerve. This nerve is responsible for controlling the muscles of facial expression, and it also carries sensory information from the taste buds in the front two-thirds of the tongue, and regulates saliva flow and tear production.
Facial nerve diseases can cause a variety of symptoms, depending on the specific location and extent of the nerve damage. Common symptoms include:
* Facial weakness or paralysis on one or both sides of the face
* Drooping of the eyelid and corner of the mouth
* Difficulty closing the eye or keeping it closed
* Changes in taste sensation or dryness of the mouth and eyes
* Abnormal sensitivity to sound (hyperacusis)
* Twitching or spasms of the facial muscles
Facial nerve diseases can be caused by a variety of factors, including:
* Infections such as Bell's palsy, Ramsay Hunt syndrome, and Lyme disease
* Trauma or injury to the face or skull
* Tumors that compress or invade the facial nerve
* Neurological conditions such as multiple sclerosis or Guillain-Barre syndrome
* Genetic disorders such as Moebius syndrome or hemifacial microsomia
Treatment for facial nerve diseases depends on the underlying cause and severity of the symptoms. In some cases, medication, physical therapy, or surgery may be necessary to restore function and relieve symptoms.
Decompression sickness (DCS), also known as "the bends," is a medical condition that results from dissolved gases coming out of solution in the body's tissues and forming bubbles during decompression. This typically occurs when a person who has been exposed to increased pressure at depth, such as scuba divers or compressed air workers, ascends too quickly.
The elevated pressure at depth causes nitrogen to dissolve into the blood and tissues of the body. As the diver ascends and the pressure decreases, the dissolved gases form bubbles, which can cause symptoms ranging from joint pain and rashes to paralysis and death. The risk of DCS is influenced by several factors, including depth, duration of exposure, rate of ascent, and individual susceptibility.
Prevention of DCS involves following established dive tables or using a personal decompression computer to calculate safe ascent rates and decompression stops. Additionally, proper hydration, fitness, and avoiding alcohol and tobacco before diving can reduce the risk of DCS. Treatment typically involves administering oxygen and recompression therapy in a hyperbaric chamber.
Graves' ophthalmopathy, also known as Graves' eye disease or thyroid eye disease, is an autoimmune condition that affects the eyes. It often occurs in individuals with Graves' disease, an autoimmune disorder that causes hyperthyroidism (overactive thyroid gland). However, it can also occur in people without Graves' disease.
In Graves' ophthalmopathy, the immune system attacks the tissue behind the eyes, causing inflammation and enlargement of the muscles, fatty tissue, and connective tissue within the orbit (eye socket). This leads to symptoms such as:
1. Protrusion or bulging of the eyes (exophthalmos)
2. Redness and swelling of the eyelids
3. Double vision (diplopia) due to restricted eye movement
4. Pain and discomfort, especially when looking up, down, or sideways
5. Light sensitivity (photophobia)
6. Tearing and dryness in the eyes
7. Vision loss in severe cases
The treatment for Graves' ophthalmopathy depends on the severity of the symptoms and may include medications to manage inflammation, eye drops or ointments for dryness, prisms to correct double vision, or surgery for severe cases.
In medical terms, the orbit refers to the bony cavity or socket in the skull that contains and protects the eye (eyeball) and its associated structures, including muscles, nerves, blood vessels, fat, and the lacrimal gland. The orbit is made up of several bones: the frontal bone, sphenoid bone, zygomatic bone, maxilla bone, and palatine bone. These bones form a pyramid-like shape that provides protection for the eye while also allowing for a range of movements.
A spasm is a sudden, involuntary contraction or tightening of a muscle, group of muscles, or a hollow organ such as the ureter or bronchi. Spasms can occur as a result of various factors including muscle fatigue, injury, irritation, or abnormal nerve activity. They can cause pain and discomfort, and in some cases, interfere with normal bodily functions. For example, a spasm in the bronchi can cause difficulty breathing, while a spasm in the ureter can cause severe pain and may lead to a kidney stone blockage. The treatment for spasms depends on the underlying cause and may include medication, physical therapy, or lifestyle changes.
The lumbar vertebrae are the five largest and strongest vertebrae in the human spine, located in the lower back region. They are responsible for bearing most of the body's weight and providing stability during movement. The lumbar vertebrae have a characteristic shape, with a large body in the front, which serves as the main weight-bearing structure, and a bony ring in the back, formed by the pedicles, laminae, and processes. This ring encloses and protects the spinal cord and nerves. The lumbar vertebrae are numbered L1 to L5, starting from the uppermost one. They allow for flexion, extension, lateral bending, and rotation movements of the trunk.
The glossopharyngeal nerve, also known as the ninth cranial nerve (IX), is a mixed nerve that carries both sensory and motor fibers. It originates from the medulla oblongata in the brainstem and has several functions:
1. Sensory function: The glossopharyngeal nerve provides general sensation to the posterior third of the tongue, the tonsils, the back of the throat (pharynx), and the middle ear. It also carries taste sensations from the back one-third of the tongue.
2. Special visceral afferent function: The nerve transmits information about the stretch of the carotid artery and blood pressure to the brainstem.
3. Motor function: The glossopharyngeal nerve innervates the stylopharyngeus muscle, which helps elevate the pharynx during swallowing. It also provides parasympathetic fibers to the parotid gland, stimulating saliva production.
4. Visceral afferent function: The glossopharyngeal nerve carries information about the condition of the internal organs in the thorax and abdomen to the brainstem.
Overall, the glossopharyngeal nerve plays a crucial role in swallowing, taste, saliva production, and monitoring blood pressure and heart rate.
The cerebellopontine angle (CPA) is a narrow space located at the junction of the brainstem and the cerebellum, where the pons and cerebellum meet. This region is filled with several important nerves, blood vessels, and membranous coverings called meninges. The CPA is a common site for various neurological disorders because it contains critical structures such as:
1. Cerebellum: A part of the brain responsible for coordinating muscle movements, maintaining balance, and fine-tuning motor skills.
2. Pons: A portion of the brainstem that plays a role in several vital functions, including facial movements, taste sensation, sleep regulation, and respiration.
3. Cranial nerves: The CPA is home to the following cranial nerves:
* Vestibulocochlear nerve (CN VIII): This nerve has two components - cochlear and vestibular. The cochlear part is responsible for hearing, while the vestibular part contributes to balance and eye movement.
* Facial nerve (CN VII): This nerve controls facial expressions, taste sensation in the anterior two-thirds of the tongue, salivary gland function, and lacrimation (tear production).
4. Blood vessels: The CPA contains critical blood vessels like the anterior inferior cerebellar artery (AICA), which supplies blood to various parts of the brainstem, cerebellum, and cranial nerves.
5. Meninges: These are protective membranes surrounding the brain and spinal cord. In the CPA, the meninges include the dura mater, arachnoid mater, and pia mater.
Disorders that can affect the structures in the cerebellopontine angle include acoustic neuromas (vestibular schwannomas), meningiomas, epidermoids, and arteriovenous malformations. These conditions may cause symptoms such as hearing loss, tinnitus (ringing in the ears), vertigo (dizziness), facial weakness or numbness, difficulty swallowing, and imbalance.
Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.
Neurosurgical procedures are operations that are performed on the brain, spinal cord, and peripheral nerves. These procedures are typically carried out by neurosurgeons, who are medical doctors with specialized training in the diagnosis and treatment of disorders of the nervous system. Neurosurgical procedures can be used to treat a wide range of conditions, including traumatic injuries, tumors, aneurysms, vascular malformations, infections, degenerative diseases, and congenital abnormalities.
Some common types of neurosurgical procedures include:
* Craniotomy: A procedure in which a bone flap is temporarily removed from the skull to gain access to the brain. This type of procedure may be performed to remove a tumor, repair a blood vessel, or relieve pressure on the brain.
* Spinal fusion: A procedure in which two or more vertebrae in the spine are fused together using bone grafts and metal hardware. This is often done to stabilize the spine and alleviate pain caused by degenerative conditions or spinal deformities.
* Microvascular decompression: A procedure in which a blood vessel that is causing pressure on a nerve is repositioned or removed. This type of procedure is often used to treat trigeminal neuralgia, a condition that causes severe facial pain.
* Deep brain stimulation: A procedure in which electrodes are implanted in specific areas of the brain and connected to a battery-operated device called a neurostimulator. The neurostimulator sends electrical impulses to the brain to help alleviate symptoms of movement disorders such as Parkinson's disease or dystonia.
* Stereotactic radiosurgery: A non-invasive procedure that uses focused beams of radiation to treat tumors, vascular malformations, and other abnormalities in the brain or spine. This type of procedure is often used for patients who are not good candidates for traditional surgery due to age, health status, or location of the lesion.
Neurosurgical procedures can be complex and require a high degree of skill and expertise. Patients considering neurosurgical treatment should consult with a qualified neurosurgeon to discuss their options and determine the best course of action for their individual situation.
Microcirculation is the circulation of blood in the smallest blood vessels, including arterioles, venules, and capillaries. It's responsible for the delivery of oxygen and nutrients to the tissues and the removal of waste products. The microcirculation plays a crucial role in maintaining tissue homeostasis and is regulated by various physiological mechanisms such as autonomic nervous system activity, local metabolic factors, and hormones.
Impairment of microcirculation can lead to tissue hypoxia, inflammation, and organ dysfunction, which are common features in several diseases, including diabetes, hypertension, sepsis, and ischemia-reperfusion injury. Therefore, understanding the structure and function of the microcirculation is essential for developing new therapeutic strategies to treat these conditions.
Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:
1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.
Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.
Medical Definition:
Magnetic Resonance Imaging (MRI) is a non-invasive diagnostic imaging technique that uses a strong magnetic field and radio waves to create detailed cross-sectional or three-dimensional images of the internal structures of the body. The patient lies within a large, cylindrical magnet, and the scanner detects changes in the direction of the magnetic field caused by protons in the body. These changes are then converted into detailed images that help medical professionals to diagnose and monitor various medical conditions, such as tumors, injuries, or diseases affecting the brain, spinal cord, heart, blood vessels, joints, and other internal organs. MRI does not use radiation like computed tomography (CT) scans.
Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.
Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.
Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.
Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.
Microvascular decompression
Hemifacial spasm
John H. Sampson
Trigeminal neuralgia
Geniculate ganglionitis
Dirk De Ridder (neurosurgeon)
Peter J. Jannetta
Günther C. Feigl
Elad Levy
Neuralgia
Atypical trigeminal neuralgia
Superior oblique myokymia
Chemoreceptor trigger zone
Dextroscope
Joseph Maroon
Nerve compression syndrome
Multiple sclerosis signs and symptoms
Cluster headache
Neurosurgery
Hypoxia (medical)
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Trigeminal nerve4
- During surgery at The Jewish Hospital - Mercy Health, Dr. Gozal accessed the trigeminal nerve through a one-inch opening in Kayla's skull behind her right ear. (mayfieldclinic.com)
- If you damage your trigeminal nerve through oral or sinus surgery, a stroke or from facial trauma, you may feel facial nerve pain that's similar to the symptoms of trigeminal neuralgia. (clevelandclinic.org)
- He has had multiple brain surgeries including a trigeminal nerve decompression surgery but only Sphenopalatine Ganglion Blocks have helped. (sleepandhealth.com)
- Trigeminal neuralgia secondary to blood vessel compression of the trigeminal nerve can be treated successfully with a neurosurgical procedure called microvascular decompression. (sgh.com.sg)
Posterior fossa1
- Comparative analysis of endoscopic assisted and purely microvascular decompression for posterior fossa cranial nerves. (osu.edu)
Rhizotomy1
- However, the drug related side effects are high, so patients are opting for various types of surgical procedures for the treatment of trigeminal neuralgia like micro-vascular decompression, rhizotomy, and stereotactic radiosurgery. (briskinsights.com)
Nerve18
- Microvascular decompression (MVD), also known as the Jannetta procedure, is a neurosurgical procedure used to treat trigeminal neuralgia (along with other cranial nerve neuralgias), a pain syndrome characterized by severe episodes of intense facial pain, and hemifacial spasm. (wikipedia.org)
- In severe cases, when pain is difficult to treat, surgery to take pressure off the glossopharyngeal nerve may be needed. (medlineplus.gov)
- Optic nerve decompression surgery (also known as optic nerve sheath decompression surgery) involves cutting slits or a window in the optic nerve sheath to allow cerebrospinal fluid to escape, thereby reducing the pressure around the optic nerve. (aetna.com)
- Initial results of uncontrolled studies suggested that optic nerve sheath decompression was a promising treatment of progressive visual loss in patients with NAION. (aetna.com)
- To resolve the controversy over the effectiveness of optic nerve decompression for NAION, the National Eye Institute sponsored the Ischemic Optic Neuropathy Decompression Trial, a multicenter, randomized controlled clinical trial of optic nerve decompression surgery for patients with NAION. (aetna.com)
- The investigators concluded that optic nerve decompression surgery is not an effective treatment for NAION, and in fact, may increase the risk of progressive visual loss in NAION patients. (aetna.com)
- A structured evidence review (Dickersin and Manheimer, 2002) concluded that "[r]esults from the Ischemic Optic Neuropathy Decompression Trial indicate that optic nerve decompression surgery for nonarteritic ischemic optic neuropathy is not effective. (aetna.com)
- A Cochrane review (Dickersin et al, 2012) concluded that results from the single trial indicate no evidence of a beneficial effect of optic nerve decompression surgery for NAION. (aetna.com)
- The purpose of the surgery is to insert a barrier between the nerve and the blood vessel to relieve the pressure. (loudwire.com)
- The surgery involves microvascular decompression of the vessel near the brainstem to relieve pressure on the facial nerve. (asoprs.org)
- Microvascular decompression is a minimally invasive surgical procedure using endoscopes to relieve abnormal compression of a cranial nerve. (upmc.com)
- In addition to microvascular decompression surgery, UPMC offers treatment options for cranial nerve disorders not always available elsewhere. (upmc.com)
- The second surgery revealed that the sponge had become fragile, losing the ability to absorb the impact of pulsatile compression of the offending artery on the root exit zone of her facial nerve. (surgicalneurologyint.com)
- Dr James Laban MBBS BSc (Hons) FRCS (Neuro.Surg) FRACS is a neurosurgeon specialising in the treatment of trigeminal neuralgia and hemifacial spasm, brain tumours, spinal surgery and peripheral nerve surgery. (neurosciences.com.au)
- Peripheral nerve surgery including carpal tunnel surgery, ulnar nerve decompression, meralgia paraesthetica, common peroneal nerve palsy and nerve sheath tumours (schwannomas and neurofibromas). (neurosciences.com.au)
- Dr Laban specialises in state-of-the-art spine, brain and peripheral nerve surgery, using minimally invasive techniques, robotics and computer-guidance. (neurosciences.com.au)
- Dr Laban is an expert in specialist spinal disorders, cranial neurosurgery (including trigeminal neuralgia, hemifacial spasm and brain tumours) and peripheral nerve surgery. (neurosciences.com.au)
- 8 clinics specializing in Neurosurgery and Orthopedic surgery providing treatment of Tarsal tunnel syndrome Tarsal tunnel syndrome is a painful condition caused by compression of the tibial nerve as it passes through the tarsal tunnel in the ankle. (doctor.global)
Hemifacial12
- Fernández-Conejero I, Ulkatan S, Sen C, Deletis V. Intra-operative neurophysiology during microvascular decompression for hemifacial spasm. (neurocare.ai)
- Operative Findings of over 5000 Microvascular Decompression Surgeries for Hemifacial Spasm: Our Perspective and Current Updates. (bvsalud.org)
- The effectiveness of microvascular decompression in treating hemifacial spasm is widely accepted. (surgicalneurologyint.com)
- However, some experience recurrence of hemifacial spasm after successful decompression surgery. (surgicalneurologyint.com)
- A female underwent microvascular decompression to treat her hemifacial spasm 6 years ago. (surgicalneurologyint.com)
- Six years later, her hemifacial spasm recurred and she underwent a second surgery. (surgicalneurologyint.com)
- We report a case in which degeneration of material, a sponge (polyurethane), used in decompression surgery caused delayed recurrence of hemifacial spasm. (surgicalneurologyint.com)
- One of the standard treatments for hemifacial spasm is microvascular decompression. (surgicalneurologyint.com)
- We encountered a case showing recurrence of hemifacial spasm 6 years after successful decompression surgery. (surgicalneurologyint.com)
- We caution that a similar choice of prosthetic material for decompression may cause delayed recurrence of hemifacial spasm after initial success in decompression surgery. (surgicalneurologyint.com)
- She was admitted to our hospital for microvascular decompression surgery for her hemifacial spasm. (surgicalneurologyint.com)
- Her hemifacial spasm disappeared completely 3 days after the decompression surgery. (surgicalneurologyint.com)
Treatments2
- Retrieved from Columbia University Irving Medical Center: https://www.neurosurgery.columbia.edu/patient-care/treatments/microvascular-decompression. (neurocare.ai)
- When medications and other treatments don't work, the last resort is surgery. (loudwire.com)
Neurological Surgery1
- For more information about Montefiore's Department of Neurological Surgery, please contact us at (718) 920-7400. (montefiore.org)
Procedure5
- To undergo Microvascular Decompression (MVD) surgery is not an easy decision to make and this guide is intended to give you an idea of what it might be like to undergo the procedure and thereby help you decide if it is for you. (tna.org.uk)
- A Facebook group, Healing Meditation for H.R. (of Bad Brains) , was created by the singer's wife and caregiver, Lori Carns Hudson, as a means for fans to channel their positive messages and good vibes towards H.R. as he prepared for surgery, during the procedure and his subsequent recovery. (loudwire.com)
- Neurovascular decompression: the procedure of choice? (thejns.org)
- Microvascular decompression (MVD) is a surgical procedure that involves redirecting or removing an artery or vein that is compressing one of the 12 cranial nerves, nerves that stem directly from the brain as opposed to the spinal cord. (neurosurgerycnj.com)
- The type of brain surgery or procedure is determined by the condition of the patient, the overall health of the patient and the location within the brain/cranial area which is affected. (neurosurgerymedassociates.com)
Discectomy1
- minimally invasive laminectomy and microdiscectomy, anterior cervical discectomy and fusion (ACDF), posterior lumbar inter body fusion (PLIF), transformational lumbar inter body fusion (TLIF), extreme lateral inter body fusion (XLIF), anterior interbody fusion (ALIF), posterior cervical decompression and fusion, minimally invasive percutaneous lumbar fusion. (chesapeakeregional.com)
Undergo4
- In addition to having the proper type of pain, candidates for an MVD must also be healthy enough to undergo surgery. (wikipedia.org)
- Patients with trigeminal neuralgia (TN) and persistent or recurrent facial pain after microvascular decompression (MVD) typically undergo less invasive procedures in the hope of providing pain relief. (thejns.org)
- Candidates are also those healthy enough to undergo surgery. (neurosurgerycnj.com)
- At this point, she was eager to undergo decompression surgery again, even if it was only for inspection. (surgicalneurologyint.com)
Neurovascular1
- Microvascular decompression is used to treat a group of conditions known as neurovascular compression syndromes. (neurosurgerycnj.com)
Vascular1
- Effects of bariatric surgery on blood and vascular large extracellular vesicles according to type 2 diabetes status. (medscape.com)
Neurosurgery2
- He received his medical degree from Temple University School of Medicine in Philadelphia, and completed his general surgery internship and neurosurgery residency at Medical College of Virginia in Richmond, Va. (chesapeakeregional.com)
- The fact that pain can be relieved through MVD surgery makes it a very-sought after and important operation in the field of neurosurgery. (neurosurgerycnj.com)
Spine surgery2
- His special interests include minimally-invasive spine surgery. (chesapeakeregional.com)
- Here, we closely work with leading therapists and pain management doctors, making it possible to create non-invasive treatment plans that prioritize help you heal - all without relying on lower back or spine surgery. (themorrisonclinic.com)
Neurosurgical2
- Microvascular decompression is a commonly used neurosurgical treatment for different neuropathologies. (neurocare.ai)
- Dr. Shutack is board-certified by the American Board of Neurosurgical Surgery and a fellow of the American Association of Neurological Surgeons. (chesapeakeregional.com)
Cervical1
- I recently had major surgery on my cervical spine. (alextaghvamd.com)
Brain Tumor3
- Whether you've been diagnosed with brain cancer or a benign brain tumor, the prospect of brain surgery and treatment can feel overwhelming. (adventhealth.com)
- So, if brain tumor surgery can't remove the tumor entirely, radiation therapy may be a good option. (adventhealth.com)
- If you need complex brain tumor surgery, you can rest easier knowing that our team has access to advanced technologies like Synaptive Medical Inc.'s BrightMatterâ„¢ system. (adventhealth.com)
Stimulation1
- He also performs spinal cord stimulation and microvascular decompression for chronic pain syndromes and trigeminal neuralgia. (superdoctors.com)
Facial Pain2
- An excellent facial pain outcome (no pain, no medications required) was achieved and maintained for 80% and 75% of patients at 1 and 3 years after surgery, respectively. (thejns.org)
- Patients with persistent or recurrent TN should be considered for repeat PFE, especially if other less invasive surgeries have not relieved their facial pain. (thejns.org)
Mechanism2
- it is a very useful test in the detection mechanism to prevent intraoperative hearing loss since it is one of the most common iatrogenic events caused during microvascular decompression surgery. (neurocare.ai)
- However, few reports have addressed the mechanism of recurrence after successful decompression surgery. (surgicalneurologyint.com)
Hydrocephalus1
- Neurosurgeons perform a craniotomy as a life-saving surgery for patients with brain lesions, tumors, hydrocephalus , blood clots (hematoma), foreign body removals such as bullets, or traumatic brain damage (TBI). (longhornbrainandspine.com)
Vessels1
- On the Surgical Implications of Peritrigeminal Perforating Vessels in Microvascular Decompression. (cornell.edu)
Epilepsy2
- These efforts are centered on improving surgery for patients with epilepsy and brain tumors, particularly those whose pathology is intimately involved with critical brain regions. (dana-farber.org)
- In epilepsy surgery, neurosurgeons use this technique to remove the portions of the brain that cause seizures. (longhornbrainandspine.com)
Incision3
- The following photographs give you an idea of what a typical MVD incision looks like immediately after surgery and then sometime later after it has healed. (tna.org.uk)
- The surgery consists of a linear incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar. (upmc.com)
- Because of the evolving technology and new and improved brain surgery techniques, nowadays some procedures can be performed without making an incision. (neurosurgerymedassociates.com)
Chronic pain1
- Years of chronic pain / Atypical Trigeminal Neuralgia, multiple failed surgeries, extractions, sinus surgeries and a cornucopia of poly-pharmaceuticals. (sleepandhealth.com)
Suboccipital1
- We carried out microvascular decompression surgery with a lateral suboccipital approach and placed a sponge (polyurethane) between the PICA and the brainstem, fixing them with fibrin glue [ Figure 1a ]. (surgicalneurologyint.com)
Surgeon1
- The viability of surgery, and which type, is judged for each patient individually by a well-qualified surgeon. (neurosurgerycnj.com)
Treatment9
- Among the patients who were operated on by our team, the mean interval from diagnosis to surgery was 8.2 years, and more than half of them learned of the possibility of surgical treatment only through a personal search for information on the condition. (aerzteblatt.de)
- In addition to established symptomatic treatment in the shape of local injections of botulinum toxin, we will focus in particular on the option of microvascular decompression, since this currently still represents the only long-term and causal therapeutic option. (aerzteblatt.de)
- Microvascular decompression (MVD) is the first choice in patients with classic trigeminal neuralgia (TGN) that could not be sufficiently controlled by pharmacological treatment. (biomedcentral.com)
- Patients should be offered surgery if pain is not sufficiently controlled medically or if medical treatment is poorly tolerated. (medscape.com)
- UPMC's neurosurgeons are among the most experienced in the world in performing microvascular decompression and have been pioneering the treatment for more than 25 years. (upmc.com)
- In a scientific comparison of the various surgical procedures, microvascular decompression (MVD) represented the most effective and safe surgical option for the treatment of trigeminal neuralgia. (neurosurgerycnj.com)
- Trigeminal Neuralgia Treatment Market By Treatment (Drug Based, Surgery) - Growth, Future Prospects And Competitive Analysis, 2017. (briskinsights.com)
- New technology and surgery techniques mean you have more treatment options than ever before. (adventhealth.com)
- This traditional approach may be used as a follow-up treatment to surgery or radiation therapy and is especially helpful if you have slow-growing tumors or tumors that return after treatment. (adventhealth.com)
Neuralgia4
- Patients most likely to benefit from a microvascular decompression have a classic form of trigeminal neuralgia. (wikipedia.org)
- Microvascular decompression for trigeminal neuralgia. (medlineplus.gov)
- What kind of surgery is recommended to treat trigeminal neuralgia? (healthtap.com)
- Mayo Clinic doctors trained in brain and nervous system conditions (neurologists), brain and nervous system surgery (neurosurgeons), brain imaging (neuroradiology), and dental specialties have extensive experience diagnosing and treating trigeminal neuralgia. (greatgreenwedding.com)
Numbness1
- Some of the risks that accompany this delicate surgery are, for example - hemorrhages, infections, numbness and/or weakness of the facial musculature, hearing loss, leaking of the spinal fluid, etc. (neurocare.ai)
Patients10
- in fact, significantly more patients in the surgery group had progressive loss of vision than patients who received only careful follow-up. (aetna.com)
- In patients with classical TN, microvascular decompression is recommended as first-line surgery. (medscape.com)
- Four patients (14%) who underwent operations elsewhere had incorrect cranial nerves decompressed at their first surgery. (thejns.org)
- Two patients (7%) had hearing loss after surgery. (thejns.org)
- This surgery is successful for some but not all patients. (asoprs.org)
- Many patients still require botulinum toxin injections after myectomy surgery. (asoprs.org)
- Although healthy older patients can well tolerate surgery, MVD is usually recommended to those under age 70 who are at lower risk of complications from general anesthesia. (neurosurgerycnj.com)
- In the USA, insured patients reported a postoperative death rate of 1.3 percent and 2.6 percent in uninsured patients after surgery for brain tumors (Gouello et al. (longhornbrainandspine.com)
- Patients need to sign the consent form before the surgery. (longhornbrainandspine.com)
- Patients need to avoid taking non-steroidal anti-inflammatory medicines (ibuprofen, naproxen, etc.) and blood thinners (Coumadin, aspirin, Plavix, etc.) 7 days before surgery. (longhornbrainandspine.com)
Tumor1
- Since it gives us a better picture of your brain and tumor during surgery, we can see your tumor in real time, giving us a better chance at removing the entire tumor without damaging nearby tissue. (adventhealth.com)
Preoperative1
- 100 ] Preoperative interventions aim at optimizing the patient for surgery, including patient education, risk assessment, and medication. (surgicalneurologyint.com)
Brainstem2
- Electromyography (EMG) and Brainstem auditory evoked potentials (BAEP) are some of the most commonly used intraoperative neuromonitoring tools during microvascular decompression to treat the neuralgias and spams previously mentioned. (neurocare.ai)
- Brainstem Auditory Evoked Potential Monitoring and Neuro-Endoscopy: Two Tools to Ensure Hearing Preservation and Surgical Success during Microvascular Decompression. (neurocare.ai)
Blood vessel1
- Surgery for HFS may be contemplated if an aberrant blood vessel is found to be the cause. (asoprs.org)
Intervention2
- Microvascular decompression surgery (MVD) is a surgical intervention that aims to alleviate nerves that are being compressed usually by arteries and veins, but they can also be compressed by tumors. (neurocare.ai)
- In the long term, however, lasting relief can only be achieved by microvascular decompression, a microsurgical intervention with a relatively low risk and a high success rate. (aerzteblatt.de)
Functional2
- The Golby Lab is funded by the Brain Science Foundation, The Klarman Family Foundation, CIMIT Harvard Catalyst, and the National Institutes of Health, allowing her to assemble a team of extraordinary scientists from different backgrounds, working collaboratively to advance the field of image-guided surgery and functional brain imaging. (dana-farber.org)
- The selection of appropriate prosthetic materials is essential in such functional surgeries. (surgicalneurologyint.com)
Treat1
- What Does Microvascular Decompression Treat? (neurosurgerycnj.com)