微血管减压:在多次治疗失败后,由多利可性基底动脉引起的三角神经疼痛的有效方法
Filippos Chelmis1, Paraskevas Pakataridis1, Iliana Sorotou1
1Faculty of Medicine, Sofia University "St. Kliment Ohridski," Sofia, Bulgaria.
Journal of neurological surgery reports
|September 30, 2024
概括
来自脊椎底性 dolichoectasia (VBD) 的三神经疼痛 (TN) 是罕见的,但具有挑战性. 微血管减压 (MVD) 手术有效地缓解了患者因VBD引起的严重面部疼痛,证明MVD是可行的治疗选择.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 血管神经学 血管神经学
背景情况:
- 三神经疼痛 (TN) 带来了诊断和治疗方面的挑战,罕见的病例与脊椎巴性 dolichoectasia (VBD) 相关.
- 脊椎基性 dolichoectasia 涉及基动脉的异常扩大和延长,可能会压缩头骨神经.
研究的目的:
- 报告三神经疼痛的病例,其次是脊椎底性 dolichoectasia.
- 评估微血管减压 (MVD) 在治疗这种罕见疾病中的有效性.
主要方法:
- 一名74岁的男性患者因VBD而患有难以治愈的左侧面部疼痛,经过 retrosigmoid suboccipital craniotomy进行了MVD.
- 图像 (MRI,CT血管造影) 证实VBD压缩三角神经.
- 一个撕碎的特隆植入物被用来减压三角神经.
主要成果:
- 在8个月的随访期间,术后疼痛缓解得到并持续存在.
- 证实了 dolichoectatic 基底动脉是三角神经压缩的原因.
- 患者的整体健康状况令人满意,支持手术干预.
结论:
- 微血管减压是一种有效的治疗三角神经疼痛与脊椎骨干 dolichoectasia 相关的治疗,即使在老年患者.
- 患者评估和外科专业知识对于管理复杂的TN病例至关重要.
- 如果MVD不可行,可以考虑使用药物或放射性手术等替代治疗方法.
相关概念视频
Mitral Stenosis III: Medical Management
535
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
535
Aortic Regurgitation III: Medical Management
598
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
598
Angina IV: Management
493
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
493
Atherosclerosis III: Management
741
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
741
Peripheral Artery Disease III: Interprofessional Care
655
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
655
Peripheral Artery Disease V: Postoperative Nursing Management
630
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
630


