Optimizing microvascular decompression for trigeminal Neuralgia: Addressing vertebrobasilar ectasia challenges – A technical note

IF 1.9 Q3 CLINICAL NEUROLOGY

Brain & spine Pub Date : 2025-01-01 DOI:10.1016/j.bas.2025.104264

Pavlina Lenga , Carola Wieckhusen , Mohammad Mehdi Hajiabadi , Andreas Unterberg , Sandro M. Krieg , Rezvan Ahmadi

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Abstract

Introduction

Trigeminal neuralgia (TN) can be due vertebrobasilar ectasia (VBE), where elongated, tortuous arteries compress the trigeminal nerve, making surgical management challenging.

Research question

Does a refined microvascular decompression (MVD) technique using a “Teflon cloud” interposition offer sustained symptom relief and medication discontinuation in VBE-induced TN?

Materials and methods

Three patients with VBE-induced TN were treated between 2017 and 2024. Diagnosis was confirmed by MRI/MRA. MVD with a “Teflon cloud” was performed to cushion the nerve without extensive arterial manipulation. Postoperative outcomes were tracked over an 8-month follow-up.

Results

All patients showed immediate, complete relief of TN symptoms, with no recurrences. They discontinued TN-related medications within three months, and no significant complications occurred.

Discussion and conclusion

These findings suggest that interposition-based MVD using a Teflon cloud effectively addresses TN in the context of VBE by providing stable nerve decompression and minimizing vascular manipulation. A refined MVD with a “Teflon cloud” interposition provides safe, sustained relief for VBE-induced TN, warranting further investigation in larger patient cohorts.

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优化微血管减压三叉神经痛：解决椎基底动脉扩张的挑战-一个技术说明

三叉神经痛（TN）可能是由于椎基底动脉扩张（VBE），其中延长，弯曲的动脉压迫三叉神经，使手术治疗具有挑战性。研究问题：使用“特氟龙云”介入的精细微血管减压（MVD）技术是否能持续缓解vbe诱导的TN症状并使其停药？材料与方法对2017 - 2024年间3例vbe诱导的TN患者进行治疗。经MRI/MRA确诊。MVD采用“特氟龙云”来缓冲神经，无需广泛的动脉操作。术后随访8个月。结果所有患者TN症状立即完全缓解，无复发。患者在3个月内停用tn相关药物，未发生明显并发症。讨论和结论这些研究结果表明，使用特氟龙云的介入MVD通过提供稳定的神经减压和最大限度地减少血管操作，有效地解决了VBE背景下的TN。采用“特氟龙云”介入的改良MVD为vbe诱导的TN提供了安全、持续的缓解，值得在更大的患者队列中进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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