椎-基底动脉压迫性三叉神经痛微血管减压手术策略及分析  

Microvascular decompression for trigeminal neuralgia caused by the vertebrobasilar artery

作　　者：王继超[1] 杨晓笙[2] 郑勇[1] 李世亭[2] 杨敏[2] 张文川[2] 仲骏[2] 王晓强[2] 

机构地区：[1]新疆维吾尔自治区人民医院神经外科,乌鲁木齐830001 [2]上海交通大学医学院附属新华医院神经外科,200092

出　　处：《中国微侵袭神经外科杂志》2015年第9期408-409,共2页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨微血管减压术治疗锥-基底动脉压迫性三叉神经痛病人的手术策略。方法回顾性分析14例锥-基底动脉压迫性三叉神经痛病人的临床资料,采用微血管减压术。椎动脉直接压迫9例,基底动脉直接压迫5例;同时伴其他小血管压迫,包括小脑上动脉8例、小脑前下动脉3例和静脉3例。压迫点位于三叉神经脑池段9例,位于入髓区（root entry zone,REZ）5例。结果术后症状即刻完全缓解11例,明显缓解3例。随访3~32个月,仅1例病人术后出现面部麻木,其他未见复发和严重并发症。结论遵循恰当的手术策略,微血管减压术是治疗椎-基底动脉压迫所致三叉神经痛最有效的手段之一。Objective To explore the surgical strategy of microvascular decompression（MVD） for trigeminal neuralgia caused by the vertebrobasilar artery. Methods Clinical data of 14 patients with trigeminal neuralgia caused by vertebrobasilar artery were analyzed retrospectively. All the patients received MVD. The vertebral artery was regarded as the direct culprit in 9 patients and the basilar artery in5. And some small vessels were also observed to be close to the nerve including the superior cerebellar artery in 8 patients, anterior inferior cerebellar artery in 3 and anterior inferior cerebellar vein in 3. The oppression point was located at the cisternal segment of the trigeminal root in 10 patients and in root entry zone in 4. Results The symptom totally disappeared in 11 patients and relieved apparently in 3. During the follow-up period of 3 to 32 months, no recurrence or complication was found, except one patient who had numbness on the face. Conclusion With a proper strategy, MVD is the most effective therapy for trigeminal neuralgia caused by vertebrobasilar artery.

关 键 词：三叉神经痛 微血管减压术 椎-基底动脉 

分 类 号：R651.3[医药卫生—外科学]