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由于前体神经瘤的二次三神经痛
Michael D Cusimano1, Kislay Kishore2
1Division of Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada; Sickkids Hospital, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada.
Handbook of clinical neurology
|October 6, 2025
概括
二次三神经疼痛,通常与前置神经瘤相关,提出了治疗挑战. 微手术提供了良好的结果,而立体射线手术 (SRS) 提供了适度的长期疼痛控制的替代方案.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 二次三神经疼痛是前庭神经瘤 (<1%) 的罕见并发症.
- 可能的原因包括神经血管冲突,直接压缩,arachnoid粘附或脑干扭曲.
- 由于文献异质性,了解确切的机制仍然具有挑战性.
研究的目的:
- 审查与前庭神经瘤相关的二次三角神经疼痛的机制和治疗结果.
- 为了比较微手术切除与立体射线手术 (SRS) 的疗效.
主要方法:
- 文献审查检查了拟议的机制和治疗策略.
- 对微手术切除和SRS的结果分析,包括单次治疗和双重向方法.
- 讨论神经血管冲突识别和管理的作用.
主要成果:
- 带有神经血管冲突治疗的前置神经瘤的微手术切除为瘤和疼痛控制带来了最好的结果.
- 立体辐射手术 (SRS) 是手术不适合的患者的一个选择,双重准显示有希望的缓解疼痛,但可能导致面部麻木.
- 使用SRS的长期疼痛控制是适度的,复发通常在两年内.
结论:
- 微手术是与二次三角神经疼痛相关的前庭神经瘤的首选治疗方法.
- SRS提供了另一种选择,特别是双重向,但需要进一步研究长期疗效和副作用的概况.
- 需要精心设计的前性研究来澄清机制,并最终比较治疗方式.
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