Leidinger Andreas, Muñoz-Hernandez Fernando, Molet-Teixidó Joan
Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Neurocirugia (Engl Ed). 2018 May-Jun;29(3):131-137. doi: 10.1016/j.neucir.2018.02.001. Epub 2018 Mar 20.
Neurovascular conflict is the most accepted hypothesis for the cause for trigeminal neuralgia. Microvascular decompression of the trigeminal nerve is the most common surgical treatment for these patients. However, despite advances in diagnostic techniques, neurovascular conflict is sometimes not detected during surgery. The aim of this paper is to systematically review all the options available to best manage this scenario.
Several techniques that could be used during microvascular decompression for trigeminal neuralgia in the absence of neurovascular conflict have been described. The success rates of these techniques, pain recurrence rates and rates of complications are also reported. Finally, we provide suggestions based on our experience.
There is no gold standard, but several techniques could be successfully used in the absence of neurovascular conflict. The use of destructive techniques, such as PSR, should be held as treatments of last resort.
神经血管冲突是三叉神经痛病因中最被认可的假说。三叉神经微血管减压术是这些患者最常见的外科治疗方法。然而，尽管诊断技术有所进步，但手术中有时仍无法检测到神经血管冲突。本文旨在系统回顾所有可用于最佳处理这种情况的方法。
已描述了几种在无微血管冲突的情况下用于三叉神经微血管减压术的技术。还报告了这些技术的成功率、疼痛复发率和并发症发生率。最后，我们根据经验提供了建议。
没有金标准，但在无微血管冲突的情况下，几种技术可以成功使用。诸如经皮半月神经节射频热凝术（PSR）等破坏性技术应作为最后的治疗手段。
