Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note

Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note

Introduction: Trigeminal neuralgia (TN) can be due vertebrobasilar ectasia (VBE), where elongated, tortuous arteries compress the trigeminal nerve, making surgical management challenging. Research question: Does a refined microvascular decompression (MVD) technique using a “Teflon cloud” interpositi...

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Bibliographic Details
Main Authors: Pavlina Lenga, Carola Wieckhusen, Mohammad Mehdi Hajiabadi, Andreas Unterberg, Sandro M. Krieg, Rezvan Ahmadi
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Brain and Spine
Subjects:
Trigeminal neuralgia
Vertebrobasilar ectasia
Neurovascular compression
Microvascular decompression
Online Access:http://www.sciencedirect.com/science/article/pii/S2772529425000839
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Summary:Introduction: Trigeminal neuralgia (TN) can be due vertebrobasilar ectasia (VBE), where elongated, tortuous arteries compress the trigeminal nerve, making surgical management challenging. Research question: Does a refined microvascular decompression (MVD) technique using a “Teflon cloud” interposition offer sustained symptom relief and medication discontinuation in VBE-induced TN? Materials and methods: Three patients with VBE-induced TN were treated between 2017 and 2024. Diagnosis was confirmed by MRI/MRA. MVD with a “Teflon cloud” was performed to cushion the nerve without extensive arterial manipulation. Postoperative outcomes were tracked over an 8-month follow-up. Results: All patients showed immediate, complete relief of TN symptoms, with no recurrences. They discontinued TN-related medications within three months, and no significant complications occurred. Discussion and conclusion: These findings suggest that interposition-based MVD using a Teflon cloud effectively addresses TN in the context of VBE by providing stable nerve decompression and minimizing vascular manipulation. A refined MVD with a “Teflon cloud” interposition provides safe, sustained relief for VBE-induced TN, warranting further investigation in larger patient cohorts.
ISSN:2772-5294

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