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[血管减压术治疗三叉神经痛]

[Vascular decompression in the treatment of trigeminal neuralgia].

作者信息

Konovalov A N, Makhmudov U B, Shimanskiĭ V N, Taniashin S V, Otarashvili I A, Pronin I N, Lebedeva M A, Orlova O R, Mingazova L R

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2008 Jul-Sep(3):3-8.

Abstract

Trigeminal neuralgia is characterized by unilateral paroxysmal facial pain. Patients often describe this pain as "the most sever pain one can suffer". Vascular compression of trigeminal nerve root directly near brainstem by artery or vein is considered the main etiology of trigeminal neuralgia. Consequently, basic pathogenetic treatment is vascular decompression of trigeminal nerve root that allows to eliminate the cause of pain. 140 patients with trigeminal neuralgia were operated in Burdenko Neurosurgical Institute since 1998 to 2007. Pain relief after surgery was observed in 96% of cases. There was no mortality in our series, overall delayed complication rate was less than 1,5%. The article deals with clinical presentation of classic trigeminal neuralgia, evaluation of the role of MRI in diagnosis of this disease and description of surgical types of arterial and venous root compression. Authors demonstrated that high effectiveness of vascular decompression depends on correct clinical diagnosis.

摘要

三叉神经痛的特点是单侧阵发性面部疼痛。患者常将这种疼痛描述为“人所能遭受的最剧烈的疼痛”。动脉或静脉在脑干附近直接对三叉神经根的血管压迫被认为是三叉神经痛的主要病因。因此,基本的致病治疗方法是三叉神经根血管减压术,该方法可消除疼痛原因。自1998年至2007年,布尔坚科神经外科研究所对140例三叉神经痛患者进行了手术。96%的病例术后疼痛缓解。我们的系列研究中无死亡病例,总体延迟并发症发生率低于1.5%。本文探讨了经典三叉神经痛的临床表现、MRI在该疾病诊断中的作用评估以及动脉和静脉根部压迫的手术类型描述。作者表明,血管减压术的高效性取决于正确的临床诊断。

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