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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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425000839 |
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| author | Pavlina Lenga Carola Wieckhusen Mohammad Mehdi Hajiabadi Andreas Unterberg Sandro M. Krieg Rezvan Ahmadi |
| author_facet | Pavlina Lenga Carola Wieckhusen Mohammad Mehdi Hajiabadi Andreas Unterberg Sandro M. Krieg Rezvan Ahmadi |
| author_sort | Pavlina Lenga |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3779f0718f584322b579c1fc86dfd32f |
| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-3779f0718f584322b579c1fc86dfd32f2025-08-20T02:15:58ZengElsevierBrain and Spine2772-52942025-01-01510426410.1016/j.bas.2025.104264Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical notePavlina Lenga0Carola Wieckhusen1Mohammad Mehdi Hajiabadi2Andreas Unterberg3Sandro M. Krieg4Rezvan Ahmadi5Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, Germany; Division of Operative Pain Management, Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, Germany; Division of Operative Pain Management, Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, Germany; Division of Operative Pain Management, Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany; Corresponding author. Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.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.http://www.sciencedirect.com/science/article/pii/S2772529425000839Trigeminal neuralgiaVertebrobasilar ectasiaNeurovascular compressionMicrovascular decompression |
| spellingShingle | Pavlina Lenga Carola Wieckhusen Mohammad Mehdi Hajiabadi Andreas Unterberg Sandro M. Krieg Rezvan Ahmadi Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note Brain and Spine Trigeminal neuralgia Vertebrobasilar ectasia Neurovascular compression Microvascular decompression |
| title | Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note |
| title_full | Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note |
| title_fullStr | Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note |
| title_full_unstemmed | Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note |
| title_short | Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note |
| title_sort | optimizing microvascular decompression for trigeminal neuralgia addressing vertebrobasilar ectasia challenges a technical note |
| topic | Trigeminal neuralgia Vertebrobasilar ectasia Neurovascular compression Microvascular decompression |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425000839 |
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