scholarly journals Neurovascular Decompression for Trigeminal Neuralgia in Elderly Patients

1999 ◽  
Vol 39 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Hiroshi RYU ◽  
Seiji YAMAMOTO ◽  
Kenji SUGIYAMA ◽  
Naoki YOKOTA ◽  
Tokutaro TANAKA
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Neurovascular Decompression

Stereotactic Radiosurgery as Initial Surgical Management for Elderly Patients with Trigeminal Neuralgia

2017 ◽  
Vol 95 (3) ◽  
pp. 158-165 ◽  
Author(s):  
Jonathan Cohen ◽  
Seyed H. Mousavi ◽  
Amir H. Faraji ◽  
Berkcan Akpinar ◽  
Edward A. Monaco ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Stereotactic Radiosurgery ◽  
Surgical Management

Typical Trigeminal Neuralgia: Comparison of Results between Patients Older and Younger than 65 Years Operated on with Microvascular Decompression by Retrosigmoid Approach

2019 ◽  
Vol 81 (01) ◽  
pp. 028-032 ◽  
Author(s):  
Luciano Mastronardi ◽  
Franco Caputi ◽  
Alessandro Rinaldi ◽  
Guglielmo Cacciotti ◽  
Raffaelino Roperto ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Microvascular Decompression ◽  
Cerebrospinal Fluid Leak ◽  
The Elderly ◽  
Retrosigmoid Approach ◽  
Younger Patients ◽  
Significant Difference ◽  
Elderly Cohort

Abstract Objective The incidence of typical trigeminal neuralgia (TN) increases with age, and neurologists and neurosurgeons frequently observe patients with this disorder at age 65 years or older. Microvascular decompression (MVD) of the trigeminal root entry zone in the posterior cranial fossa represents the etiological treatment of typical TN with the highest efficacy and durability of all treatments. This procedure is associated with possible risks (cerebellar hematoma, cranial nerve injury, stroke, and death) not seen with the alternative ablative procedures. Thus the safety of MVD in the elderly remains a topic of discussion. This study was conducted to determine whether MVD is a safe and effective treatment in older patients with TN compared with younger patients. Methods In this retrospective study, 28 patients older than 65 years (elderly cohort: mean age 70.9 ± 3.6 years) and 38 patients < 65 years (younger cohort: mean age 51.7 ± 6.3 years) underwent MVD via the keyhole retrosigmoid approach for type 1 TN (typical) or type 2a TN (typically chronic) from November 2011 to November 2017. A 75-year-old patient and three nonelderly patients with type 2b TN (atypical) were excluded. Elderly and younger cohorts were compared for outcome and complications. Results At a mean follow-up 26.0 ± 5.5 months, 25 patients of the elderly cohort (89.3%) reported a good outcome without the need for any medication for pain versus 34 (89.5%) of the younger cohort. Twenty-three elderly patients with type 1 TN were compared with 30 younger patients with type 1 TN, and no significant difference in outcomes was found (p > 0.05). Five elderly patients with type 2a TN were compared with eight younger patients with type 2a TN, and no significant difference in outcomes was noted (p > 0.05). There was one case of cerebrospinal fluid leak and one of a cerebellar hematoma, both in the younger cohort. Mortality was zero in both cohorts. Conclusions On the basis of our experience and the international literature, age itself does not seem to represent a major contraindication of MVD for TN.

Microvascular decompression for trigeminal neuralgia in elderly patients

2008 ◽  
Vol 108 (4) ◽  
pp. 689-691 ◽  
Author(s):  
Raymond F. Sekula ◽  
Edward M. Marchan ◽  
Lynn H. Fletcher ◽  
Kenneth F. Casey ◽  
Peter J. Jannetta
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Microvascular Decompression ◽  
The Elderly ◽  
Outcome Data ◽  
Control Group ◽  
Younger Patients ◽  
Telephone Interviews ◽  
Second Tier

Object Although microvascular decompression (MVD) for patients with medically refractory trigeminal neuralgia (TN) is widely accepted as the treatment of choice, other “second-tier” treatments are frequently offered to elderly patients due to concerns regarding fitness for surgery. The authors sought to determine the safety and effectiveness of MVD for TN in patients older than 75 years of age. Methods The authors performed a retrospective review of medical records and conducted follow-up telephone interviews with the patients. The outcome data from 25 MVD operations for TN performed in 25 patients with a mean age of 79.4 years (range 75–88 years) were compared with those of a control group of 25 younger patients with a mean age of 42.3 years (range 17–50 years) who underwent MVDs during the same 30-month period from July 2000 to December 2003. Results Initial pain relief was achieved in 96% of the patients in both groups (p = 1.0). There were no operative deaths in either group. After an average follow-up period of 44 and 52 months, 78 and 72% of patients in the elderly and control groups, respectively, remained pain free without medication (p = 0.74). Conclusions Microvascular decompression is an effective treatment for elderly patients with TN. The authors' experience suggests that the rate of complications and death after MVD for TN in elderly patients is no different from the rate in younger patients.

Microvascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis

2011 ◽  
Vol 114 (1) ◽  
pp. 172-179 ◽  
Author(s):  
Raymond F. Sekula ◽  
Andrew M. Frederickson ◽  
Peter J. Jannetta ◽  
Matthew R. Quigley ◽  
Khaled M. Aziz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Prospective Study ◽  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Meta Analysis ◽  
Complication Rates ◽  
Significant Difference

Object Because the incidence of trigeminal neuralgia (TN) increases with age, neurosurgeons frequently encounter elderly patients with this disorder. Although microvascular decompression (MVD) is the only etiological therapy for TN with the highest initial efficacy and durability of all treatments, it is nonetheless associated with special risks (cerebellar hematoma, cranial nerve injury, stroke, and death) not seen with the commonly performed ablative procedures. Thus, the safety of MVD in the elderly remains a concern. This prospective study and systematic review with meta-analysis was conducted to determine whether MVD is a safe and effective treatment in elderly patients with TN. Methods In this prospectively conducted analysis, 36 elderly patients (mean age 73.0 ± 5.9 years) and 53 nonelderly patients (mean age 52.9 ± 8.8 years) underwent MVD over the study period. Outcome and complication data were recorded. The authors also conducted a systematic review of the English literature published before December 2009 and providing outcomes and complications of MVD in patients with TN above the age of 60 years. Pooled complication rates of stroke, death, cerebellar hematoma, and permanent cranial nerve deficits were analyzed. Results Thirty-one elderly patients (86.1%) reported an excellent outcome after MVD (mean follow-up 20.0 ± 7.0 months). Twenty-five elderly patients with Type 1 TN were compared with 26 nonelderly patients with Type 1 TN, and no significant difference in outcomes was found (p = 0.046). Three elderly patients with Type 2a TN were compared with 12 nonelderly patients with Type 2a TN, and no significant difference in outcomes was noted (p = 1.0). Eight elderly patients with Type 2b TN were compared with 15 nonelderly patients with Type 2b TN, and no significant difference in outcomes was noted (p = 0.086). The median length of stay between cohorts was compared, and no significant difference was noted (2 days for each cohort, p = 0.33). There were no CSF leaks, no cerebellar hematomas, no strokes, and no deaths. Eight studies (1334 patients) met the inclusion criteria for the meta-analysis. For none of the complications was the incidence significantly more frequent in elderly patients than in the nonelderly. Conclusions Although patient selection remains important, the authors' experience and the results of this systematic review with meta-analysis suggest that the majority of elderly patients with TN can safely undergo MVD.

Withdrawal reaction of carbamazepine after neurovascular decompression for trigeminal neuralgia: A preliminary study

2014 ◽  
Vol 338 (1-2) ◽  
pp. 43-45 ◽  
Author(s):  
Min-Jie Chen ◽  
Wei-Jie Zhang ◽  
Zhi-Lin Guo ◽  
Wen-Hao Zhang ◽  
Ying Chai ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Withdrawal Reaction ◽  
Preliminary Study ◽  
Neurovascular Decompression

Are peripheral neurectomies of value in the treatment of trigeminal neuralgia? An analysis of new cases and cases involving previous radiofrequency gasserian thermocoagulation

1996 ◽  
Vol 85 (3) ◽  
pp. 435-437 ◽  
Author(s):  
Raj Murali ◽  
Richard L. Rovit
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Excellent Result ◽  
Safe Procedure ◽  
Content Type ◽  
Limited Life ◽  
Experienced Pain ◽  
Good Pain Relief ◽  
Peripheral Neurectomy ◽  
Fine Print

✓ The indications, advantages, complications, and benefits of peripheral neurectomy in patients with trigeminal neuralgia were studied in detail in 40 patients treated between 1982 and 1991. Twenty-eight patients had previously received radiofrequency thermocoagulation; peripheral neurectomy was performed for pain recurrence. These patients had excellent or good pain relief for at least 5 years postsurgery. Of the 12 patients who had peripheral neurectomy as their only procedure, seven had an excellent result and five had a good result. Five of the patients had recurrence of pain after 2 years but responded well to a second neurectomy. Elderly patients who experienced pain in the first and second divisions of the trigeminal distributions were the best candidates. Peripheral neurectomy is an effective, safe procedure for elderly patients who suffer from trigeminal neuralgia and have a limited life span.

scholarly journals Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain

2006 ◽  
Vol 64 (4) ◽  
pp. 983-989 ◽  
Author(s):  
Manoel J. Teixeira ◽  
Silvia R.D.T. Siqueira ◽  
Gilberto M. Almeida
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Success Rate ◽  
Facial Pain ◽  
Clinical Findings ◽  
Atypical Facial Pain ◽  
Post Herpetic Neuralgia ◽  
Trigeminal Neuropathy ◽  
Idiopathic Trigeminal Neuralgia ◽  
Neurovascular Decompression

OBJECTIVE: To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia). METHOD: Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits. RESULTS: Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief. CONCLUSION: Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.

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