Arrese Ignacio, Sarabia Rosario
Unit of Vascular Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain.
Unit of Vascular Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain.
Neurocirugia (Astur). 2016 Nov-Dec;27(6):304-309. doi: 10.1016/j.neucir.2016.05.003. Epub 2016 Jul 18.
Vertebrobasilar dolichoectasia is a condition in which there is elongation and dilatation of the vertebral and basilar arteries. Few studies have been reported that focus on cases of trigeminal neuralgia (TN) secondary to vertebrobasilar dolichoectasia (VD) and treated by microvascular decompression (MD).
A case is presented of trigeminal neuralgia caused by vertebral artery compression. An analysis of the microsurgical technique, as well as a systematic review of the literature about this uncommon nerve compression is performed, in order to investigate, by pooled case analysis, if MD is a good option for this type of patient.
A total of 7 studies were included for analysis, to which the present case was added, making a total of 56 patents. There were excellent results in 53 cases, and partial recovery in 3, with a mean follow up of 54 months. No major complications were found.
The good clinical results and absence of postoperative mortality or severe morbidity in our pooled case series lead us to recommend MD as the preferred treatment for TN caused by VD in patients in whom major surgery is not contraindicated.
椎基底动脉延长扩张症是一种椎动脉和基底动脉发生延长和扩张的病症。很少有研究关注继发于椎基底动脉延长扩张症（VD）并通过微血管减压术（MD）治疗的三叉神经痛（TN）病例。
本文报告一例由椎动脉压迫引起的三叉神经痛病例。对显微外科技术进行分析，并对有关这种罕见神经压迫的文献进行系统综述，以便通过汇总病例分析来研究微血管减压术对这类患者是否是一种好的选择。
共纳入7项研究进行分析，并将本病例纳入其中，总计56例患者。53例效果极佳，3例部分恢复，平均随访54个月。未发现重大并发症。
我们汇总病例系列中的良好临床结果以及无术后死亡或严重并发症情况，使我们建议在无重大手术禁忌的患者中，微血管减压术作为由椎基底动脉延长扩张症引起的三叉神经痛的首选治疗方法。
