Ryu H, Yamamoto S, Sugiyama K, Yokota N, Tanaka T
Department of Neurosurgery, Hamamatsu University School of Medicine.
Neurol Med Chir (Tokyo). 1999 Mar;39(3):226-9; discussion 229-30. doi: 10.2176/nmc.39.226.
The operative findings and outcomes of neurovascular decompression for trigeminal neuralgia were compared between patients aged 75 years and older (elderly group, 17 patients) and patients aged under 75 years (nonelderly group, 115 patients). There were no statistically significant differences in the operative findings or outcomes between the two groups, except in the percentage of patients who had been treated with carbamazepine. Neurovascular decompression for trigeminal neuralgia can be performed in elderly patients with the same operative results as in nonelderly patients. If other treatments (especially carbamazepine treatment) prove ineffective, neurovascular decompression should be considered in elderly patients before they become too old to undergo surgery. However, neurovascular decompression in elderly patients requires great care, as the venous system, including the superior petrosal vein, should be preserved and retraction of the cerebellum should be avoided whenever possible to maintain correct blood circulation in the cerebellum and brainstem.
对75岁及以上患者（老年组，17例）和75岁以下患者（非老年组，115例）行三叉神经痛神经血管减压术的手术发现及结果进行了比较。除接受卡马西平治疗的患者百分比外，两组的手术发现或结果无统计学显著差异。老年患者行三叉神经痛神经血管减压术的手术效果与非老年患者相同。如果其他治疗（尤其是卡马西平治疗）证明无效，在老年患者因年龄太大而无法接受手术之前，应考虑对其进行神经血管减压术。然而，老年患者行神经血管减压术需要格外小心，因为应保留包括岩上静脉在内的静脉系统，并且应尽可能避免牵拉小脑，以维持小脑和脑干的正确血液循环。
