Department of Neurology, Gold Coast Hospital, 108 Nerang Street, Southport, QLD, 4215, Australia.
Curr Pain Headache Rep. 2013 May;17(5):332. doi: 10.1007/s11916-013-0332-0.
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are primary headache disorders. Evidence suggests that SUNCT/SUNA have similar pathophysiology to the trigeminal autonomic cephalalgias and involves the trigeminal autonomic reflex. This review provides an overview of microvascular decompression of the trigeminal nerve and other surgical therapeutic options for SUNCT/SUNA. We have undertaken a mini-meta-analysis of available case reports and case series with the aim of providing recommendations for the use of such therapies in SUNCT/SUNA. There is some evidence supporting microvascular decompression of the trigeminal nerve in selected patients who have medically refractory SUNCT/SUNA and a demonstrable ipsilateral aberrant vessel on magnetic resonance imaging (MRI). We also consider what further investigations could be undertaken to assess the role of surgical interventions in the treatment of these often debilitating conditions.
短暂单侧神经性头痛伴结膜充血和流泪（SUNCT）和短暂单侧神经性头痛发作伴颅自主症状（SUNA）是原发性头痛疾病。有证据表明，SUNCT/SUNA 的病理生理学与三叉神经自主神经性头痛相似，涉及三叉神经自主反射。本综述概述了三叉神经微血管减压术和其他针对 SUNCT/SUNA 的手术治疗选择。我们对现有病例报告和病例系列进行了小型荟萃分析，旨在为 SUNCT/SUNA 中此类治疗方法的应用提供建议。有一些证据支持在有药物难治性 SUNCT/SUNA 且磁共振成像（MRI）显示同侧异常血管的特定患者中进行三叉神经微血管减压术。我们还考虑可以进行哪些进一步的检查来评估手术干预在这些常常使人衰弱的疾病中的治疗作用。
