Samii M, Matthies C
Neurosurgical Clinic, Nordstadt Hospital, Hannover, Federal Republic of Germany.
Acta Neurochir (Wien). 1995;134(3-4):148-54. doi: 10.1007/BF01417682.
Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the cranial nerves at the brainstem in the majority of cases. Trigeminal neuralgia occurring in 3.3% of acoustic neurinomas is usually assumed to be a sign of large tumour size; if associated with small tumour size, an additional pathology, such as typical vascular compression must be suspected and has to be explored at surgery. While facial paresis will usually lead to immediate radiological diagnosis of a possible cerebellopontine angle (CPA) neoplasm, facial spasm is usually not expected to be associated with a CPA tumour. We report on clinical presentation, operative findings, surgical treatment and results in 9 cases of small acoustic neurinomas associated with trigeminal neuralgia and on 4 cases associated with hemifacial spasm. The importance of the clinical characteristics is stressed; if these are typical of a vascular compression syndrome, further exploration at the time of tumour surgery and specific treatment by vascular decompression are necessary.
在大多数情况下，三叉神经痛和面肌痉挛是由脑干处颅神经的血管压迫引起的。听神经瘤患者中3.3%出现的三叉神经痛通常被认为是肿瘤体积较大的征象；如果与小肿瘤相关，则必须怀疑存在其他病理情况，如典型的血管压迫，并在手术中进行探查。虽然面部轻瘫通常会立即促使对可能的桥小脑角（CPA）肿瘤进行影像学诊断，但面肌痉挛通常预计与CPA肿瘤无关。我们报告了9例与三叉神经痛相关的小型听神经瘤以及4例与面肌痉挛相关的小型听神经瘤的临床表现、手术发现、手术治疗及结果。强调了临床特征的重要性；如果这些特征典型地表现为血管压迫综合征，则在肿瘤手术时进行进一步探查以及通过血管减压进行特异性治疗是必要的。
