Masur H, Papke K, Bongartz G, Vollbrecht K
Department of Neurology, University of Münster, Germany.
J Neurol. 1995 Jan;242(2):93-8. doi: 10.1007/BF00887823.
Three-dimensional MR tomography was used to examine the relationship between symptoms of trigeminal neuralgia and neurovascular compression of the nerve in 18 patients. The intensity of neurovascular interaction was classified according to neuroradiological criteria. We found that a radiologically defined compression or dislocation of the nerve by an artery was always associated with symptoms of trigeminal neuralgia. A simple contact between vessel and nerve, however, was also observed on the asymptomatic sides of 10 out of 18 patients. In 6 of 18 patients, in contrast, trigeminal neuralgia was present in spite of the absence of neurovascular contact. In accordance with a cited study based on autopsy and intraoperative findings, our findings indicate that, in a certain proportion of cases, trigeminal neuralgia may be caused by neurovascular compression alone, whereas in other cases, other pathogenetic factors may be involved to a varying degree or be even exclusively responsible for the development of trigeminal neuralgia. The possible significance of the method for a preoperative estimation of the success of microvascular decompression of the trigeminal nerve is discussed.
采用三维磁共振断层扫描技术对18例三叉神经痛患者的症状与神经血管压迫之间的关系进行了研究。根据神经放射学标准对神经血管相互作用的强度进行分类。我们发现，动脉对神经的放射学定义的压迫或移位总是与三叉神经痛的症状相关。然而，在18例患者中的10例无症状侧也观察到血管与神经之间存在简单接触。相比之下，18例患者中有6例尽管没有神经血管接触，但仍存在三叉神经痛。根据一项基于尸检和术中发现的引用研究，我们的研究结果表明，在一定比例的病例中，三叉神经痛可能仅由神经血管压迫引起，而在其他病例中，其他致病因素可能不同程度地参与其中，甚至可能是三叉神经痛发病的唯一原因。本文还讨论了该方法对三叉神经微血管减压术前成功评估的可能意义。
