三叉神经痛微血管减压术中异常的展神经
Aberrant Abducent Nerve During Microvascular Decompression for Trigeminal Neuralgiass.
作者信息
Borg Anouk, Zrinzo Ludvic
机构信息
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery-University College London Hospitals, Queen Square, London, United Kingdom.
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery-University College London Hospitals, Queen Square, London, United Kingdom.
出版信息
World Neurosurg. 2020 Jun;138:454-456. doi: 10.1016/j.wneu.2020.03.115. Epub 2020 Apr 3.
BACKGROUND
Microvascular decompression (MVD) is a commonly performed procedure to treat trigeminal neuralgia and hemifacial spasm. Knowledge of the variable anatomy of the cerebellopontine angle is crucial to avoid injury to cranial nerves.
CASE DESCRIPTION
A 76-year-old lady with right V1 (ophthalmic division of the trigeminal nerve) and V2 (maxillary division of the trigeminal nerve) trigeminal neuralgia, refractory to medical treatment, underwent elective MVD. Intraoperatively, a distorted course of the cisternal component of the abducent nerve was noticed, caused by an ectatic anterior inferior cerebellar artery. Careful mobilization of the offending vessel to decompress the trigeminal nerve was carried out; however, abducent nerve decompression was not attempted since its function was not compromised. Facial pain resolved postoperatively without new diplopia.
CONCLUSIONS
Careful review of imaging before surgery is recommended in order to preempt such unusual anatomic variations.
背景
微血管减压术（MVD）是治疗三叉神经痛和面肌痉挛的常用手术。了解桥小脑角的可变解剖结构对于避免损伤颅神经至关重要。
病例描述
一名76岁女性患有右侧V1（三叉神经眼支）和V2（三叉神经上颌支）三叉神经痛，药物治疗无效，接受了择期微血管减压术。术中发现展神经脑池段走行扭曲，由扩张的小脑前下动脉引起。小心地将肇事血管游离以减压三叉神经；然而，由于展神经功能未受影响，未尝试对其进行减压。术后面部疼痛缓解，未出现新的复视。
结论
建议术前仔细复查影像学检查，以预先发现此类异常解剖变异。
Zotero 插件