Clinical Research Papers:
After microvascular decompression to treat trigeminal neuralgia, both immediate pain relief and recurrence rates are higher in patients with arterial compression than with venous compression
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Lei Shi1,*, Xiaoyan Gu2,*, Guan Sun3,*, Jun Guo3,*, Xin Lin1,*, Shuguang Zhang1,* and Chunfa Qian4
1 Department of Neurosurgery and Anesthesiology, The First People’s Hospital of Kunshan affiliated with Jiangsu University, Suzhou, P. R. China
2 Department of Rehabilitation, The 454th Hospital of Chinese PLA, Nanjing, Jiangsu, China
3 Department of Neurosurgery, Fourth Affiliated Yancheng Hospital of Nantong University, Yancheng, P. R. China
4 Department of Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, P. R. China
* These authors have contributed equally to this work
Chunfa Qian, email:
Keywords: trigeminal neuralgia; microvascular decompression; arterial compression; venous compression; recurrence
Received: November 25, 2016 Accepted: January 11, 2017 Published: January 20, 2017
We explored differences in postoperative pain relief achieved through decompression of the trigeminal nerve compressed by arteries and veins. Clinical characteristics, intraoperative findings, and postoperative curative effects were analyzed in 72 patients with trigeminal neuralgia who were treated by microvascular decompression. The patients were divided into arterial and venous compression groups based on intraoperative findings. Surgical curative effects included immediate relief, delayed relief, obvious reduction, and invalid result. Among the 40 patients in the arterial compression group, 32 had immediate pain relief of pain (80.0%), 5 cases had delayed relief (12.5%), and 3 cases had an obvious reduction (7.5%). In the venous compression group, 12 patients had immediate relief of pain (37.5%), 13 cases had delayed relief (40.6%), and 7 cases had an obvious reduction (21.9%). During 2-year follow-up period, 6 patients in the arterial compression group experienced recurrence of trigeminal neuralgia, but there were no recurrences in the venous compression group. Simple artery compression was followed by early relief of trigeminal neuralgia more often than simple venous compression. However, the trigeminal neuralgia recurrence rate was higher in the artery compression group than in the venous compression group.
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