Lenga Pavlina, Wieckhusen Carola, Hajiabadi Mohammad Mehdi, Unterberg Andreas, Krieg Sandro M, Ahmadi Rezvan
Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Medical Faculty of Heidelberg, Heidelberg University Hospital, Heidelberg, Germany.
Brain Spine. 2025 Apr 24;5:104264. doi: 10.1016/j.bas.2025.104264. eCollection 2025.
Trigeminal neuralgia (TN) can be due vertebrobasilar ectasia (VBE), where elongated, tortuous arteries compress the trigeminal nerve, making surgical management challenging.
Does a refined microvascular decompression (MVD) technique using a "Teflon cloud" interposition offer sustained symptom relief and medication discontinuation in VBE-induced TN?
Three patients with VBE-induced TN were treated between 2017 and 2024. Diagnosis was confirmed by MRI/MRA. MVD with a "Teflon cloud" was performed to cushion the nerve without extensive arterial manipulation. Postoperative outcomes were tracked over an 8-month follow-up.
All patients showed immediate, complete relief of TN symptoms, with no recurrences. They discontinued TN-related medications within three months, and no significant complications occurred.
These findings suggest that interposition-based MVD using a Teflon cloud effectively addresses TN in the context of VBE by providing stable nerve decompression and minimizing vascular manipulation. A refined MVD with a "Teflon cloud" interposition provides safe, sustained relief for VBE-induced TN, warranting further investigation in larger patient cohorts.
三叉神经痛（TN）可能由椎基底动脉扩张（VBE）引起，即伸长、迂曲的动脉压迫三叉神经，这使得手术治疗具有挑战性。
使用“聚四氟乙烯云”置入的改良微血管减压术（MVD）能否在VBE诱发的TN中提供持续的症状缓解并停用药物？
2017年至2024年间对3例VBE诱发的TN患者进行了治疗。通过MRI/MRA确诊。采用“聚四氟乙烯云”进行MVD，以缓冲神经，避免广泛的动脉操作。术后随访8个月，跟踪术后结果。
所有患者的TN症状均立即完全缓解，无复发。他们在三个月内停用了与TN相关的药物，且未发生重大并发症。
这些发现表明，使用聚四氟乙烯云的基于置入的MVD通过提供稳定的神经减压并尽量减少血管操作，有效地解决了VBE背景下的TN问题。采用“聚四氟乙烯云”置入的改良MVD为VBE诱发的TN提供了安全、持续的缓解，值得在更大的患者队列中进一步研究。
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