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Glycerol injection into the trigeminal ganglion provokes a selective increase in human cerebral blood flow
Yves Roger Tran Dinh1, Claude Thurel, Alain Serrie
1Service d'Explorations Fonctionnelles du Système Nerveux., Hôpital Lariboisière, ParisFrance Laboratoire de Physiologie et Physiopathologie Cérébrovasculaire, U 182 INSERM, UA 641 CNRS, Université Paris VII, Faculté de Médecine Lariboisière-St Louis, ParisFrance Centre de Traitement de la Douleur, Hôpital Lariboisière, ParisFrance.
Abstract:
Fourteen patients suffering from idiopathic trigeminal neuralgia (refractory to medication) were treated by injection of glycerol into the trigeminal ganglion. The changes in cerebral blood flow (CBF) after glycerol injection were quantified by intravenous 133Xe emission tomography. There was a significant 11% (P less than 0.01) increase in ipsilateral CBF and an 8% (P less than 0.05) increase in contralateral CBF 1 h after glycerol injection. The interhemispheric difference was significant (P less than 0.05). The increase was significantly greater in the ipsilateral internal carotid territory, in the anterior cerebral artery and middle cerebral artery territories (superficial (P less than 0.05), deep territories (P less than 0.001]. We suggest that these changes are due to the release of substance P and/or calcitonin gene-related peptide, from terminals of the trigeminal-vascular system during glycerol injection.