微血管减压术治疗三叉神经痛的病因学研究(附84例临床分析)

目的将三叉神经痛微血管减压术结果与术前磁共振血管成像对比研究,探索术前确定三叉神经痛病因的方法。方法利用MRI三维时间飞跃破坏性梯度回聚回波序列对84例三叉神经痛病人行颅脑扫描,观察三叉神经的走形与邻近血管的关系,其中68例行手术治疗。结果MRI显示患侧三叉神经与血管密切接触79例,手术治疗68例与MRI扫描62例阳性相符,2例为岩静脉压迫并蛛网膜粘连。结论血管压迫是三叉神经痛的主要病因,微血管减压术可取得良好效果,磁共振血管成像有益于三叉神经痛的术前病因诊断。

The etiology and microvascular decompression of trigeminal neuralgia (Report of 84 cases)

Objective To study the etiology of trigemimal neurolgia(TN) by magnetic resonance angiography finding and microvascular decompression.Methods The courses of trigeminal nerve and the relationship with their neighboring blood vessels were observed. By using scanned with 3 dimensional time of flight magnetic resonance angiography in 84 patients.And 68 patients with TN were surgically treated.Results Vessel compression of the root exit zone of the trigeminal nerve were detected on 79 neuragic sides.The results of surgery were entirely consistent with MRI findings in 62 patients,petrous-vein and arachnoid membrane adhesion in two cases.Conclusion The major causes of TN might be different neurovascular compressions in the root exit zone of the fine cranial nerve.Distortion or groove of nerve and vessels are typical appearances for TN,and they are helpful in recommendation of patients with TN who might benefit from microvascular decompression.