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使用先进三维计算机图形技术可视化三叉神经痛中的神经内静脉压迫：一例说明性病例报告

The Visualization of Intraneural Venous Compression in Trigeminal Neuralgia by Using Advanced Three-Dimensional Computer Graphics: An Illustrative Case Report.

作者信息

Kanayama Seisaku, Shono Naoyuki, Inoue Masato

机构信息

Neurosurgery, Center Hospital of National Center for Global Health and Medicine, Tokyo, JPN.

Neurosurgery, The University of Tokyo Hospital, Tokyo, JPN.

出版信息

Cureus. 2024 Apr 9;16(4):e57935. doi: 10.7759/cureus.57935. eCollection 2024 Apr.

DOI:10.7759/cureus.57935
PMID:38738094
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11082426/
Abstract

Trigeminal neuralgia (TN) caused by venous compression presents challenges in surgical management, unlike the arterial type. Preoperative diagnostic certainty regarding venous etiology and anatomical relationships is crucial for surgical success. We discuss a case of TN caused by a vein passing through the nerve that was challenging to visualize on conventional MRI and was treated successfully by leveraging information from modern surgical simulation technology with 3D computer graphics. We recognized a potentially troublesome anatomical feature in advance and mitigated the risk by identifying a collateral drainage route for the causative vein, making it feasible to be sacrificed while ensuring treatment efficacy.

摘要

与动脉型三叉神经痛不同，由静脉压迫引起的三叉神经痛（TN）在外科治疗中存在挑战。术前明确静脉病因及解剖关系对于手术成功至关重要。我们讨论了一例由静脉穿过神经引起的TN病例，该静脉在传统MRI上难以显示，通过利用现代手术模拟技术和3D计算机图形学信息成功进行了治疗。我们提前识别出一个潜在的麻烦解剖特征，并通过为致病静脉确定一条侧支引流途径来降低风险，从而在确保治疗效果的同时，使牺牲该静脉成为可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f47/11082426/65404486359a/cureus-0016-00000057935-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f47/11082426/12e96ed35a56/cureus-0016-00000057935-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f47/11082426/65404486359a/cureus-0016-00000057935-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f47/11082426/12e96ed35a56/cureus-0016-00000057935-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f47/11082426/65404486359a/cureus-0016-00000057935-i02.jpg

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本文引用的文献

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J Clin Neurosci. 2023 Feb;108:19-24. doi: 10.1016/j.jocn.2022.12.016. Epub 2022 Dec 26.
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Purely venous compression in trigeminal neuralgia-can we predict the outcome of surgery.三叉神经痛中单纯静脉压迫——我们能否预测手术结果？
Acta Neurochir (Wien). 2022 Jun;164(6):1567-1573. doi: 10.1007/s00701-022-05176-z. Epub 2022 Mar 11.
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Data fusion and 3D visualization for optimized representation of neurovascular relationships in the posterior fossa.
数据融合和 3D 可视化，优化后颅窝神经血管关系的表示。
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Virtual reality-based evaluation of neurovascular conflict for the surgical planning of microvascular decompression in trigeminal neuralgia patients.基于虚拟现实的三叉神经痛患者微血管减压术神经血管冲突评估。
Neurosurg Rev. 2021 Dec;44(6):3309-3321. doi: 10.1007/s10143-021-01500-w. Epub 2021 Feb 13.
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Characteristics and management of the offending veins in microvascular decompression surgery for trigeminal neuralgia.微血管减压术治疗三叉神经痛时责任血管的特点和处理。
Neurosurg Rev. 2021 Aug;44(4):2337-2347. doi: 10.1007/s10143-020-01411-2. Epub 2020 Oct 27.
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