Decompression by Cutting the Tentorium for Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

Trigeminal neuralgia caused by vertebrobasilar dolichoectasia (VBD) is rare and challenging to treat. Some authors have reported techniques for treating trigeminal neuralgia caused by VBD using various kinds of objects including clips, Proline slings, and titanium plates. Here, we report the effecti...

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Bibliographic Details
Published in:World neurosurgery 2018-12, Vol.120, p.72-77
Main Authors: Arai, Takashi, Yamaguchi, Koji, Ishikawa, Tatsuya, Okada, Yoshikazu, Matsuoka, Go, Omura, Yoshihiro, Kawamata, Takakazu
Format: Article
Language:English
Subjects:
Adult
Aged
Humans
Male
Microvascular decompression
Microvascular Decompression Surgery - methods
Middle Aged
Trigeminal neuralgia
Trigeminal Neuralgia - diagnostic imaging
Trigeminal Neuralgia - etiology
Trigeminal Neuralgia - surgery
Vertebrobasilar dolichoectasia
Vertebrobasilar Insufficiency - complications
Vertebrobasilar Insufficiency - diagnostic imaging
Vertebrobasilar Insufficiency - surgery
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Summary:Trigeminal neuralgia caused by vertebrobasilar dolichoectasia (VBD) is rare and challenging to treat. Some authors have reported techniques for treating trigeminal neuralgia caused by VBD using various kinds of objects including clips, Proline slings, and titanium plates. Here, we report the effectiveness of cutting and splitting of the tentorium in 3 patients with trigeminal neuralgia. The clinical results were good, the pain disappeared in all patients without medication, and no complications occurred. In cases of trigeminal neuralgia caused by VBD, this technique may be as useful as traditional microvascular decompression around the trigeminal nerve root entry zone. •Cutting and splitting the tentorium is simple and safe and may be effective for managing trigeminal neuralgia due to VBD.•By the cutting the tentorium, the surgical field is wide.•Observation of offending vessels other than VBD becomes easy.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2018.07.282