Applied value of vascular compression grading in prognosis evaluation of patients with trigeminal neuralgia
10.3760/cma.j.cn115354-20200814-00653
- VernacularTitle:血管压迫程度在三叉神经痛患者预后评估中的应用价值分析
- Author:
Dingyang LIU
1
;
Kai ZHANG
;
Tingjian WANG
;
Zhuanyi YANG
;
Xiaoyu CHEN
;
Yuxiang CAI
;
Jian LIU
;
Yanjin WANG
;
Yonghong HOU
;
Zhiquan YANG
Author Information
1. 中南大学湘雅医院神经外科，长沙 410008
- Keywords:
Trigeminal neuralgia;
Microvascular decompression;
Neurovascular compression degree;
Prognosis
- From:
Chinese Journal of Neuromedicine
2020;19(11):1104-1108
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of trigeminal nerve vascular compression grading evaluated by preoperative magnetic resonance imaging (MRI) in patients with trigeminal neuralgia (TN) after microvascular decompression (MVD).Methods:Two hundred and seventy patients with TN accepted MVD in our hospital from January 2015 to December 2017 were chosen in our study; their clinical and MRI data were retrospectively analyzed. By referring to Sindou's method and Jannetta standard, these patients were divided into patients with mild vascular compression ( n=71) and patients with severe vascular compression ( n=199) according to preoperative MRI data; these patients were divided into typical TN patients ( n=219) and atypical TN patients ( n=51) according to their symptomatic characteristics; the differences in prognoses after one year of follow-up were compared among patients from different categories. Results:The degree of intraoperative vascular compression was basically consistent with the preoperative imaging evaluation results, and the intraoperative vascular compression in 256 patients was consistent with preoperative imaging evaluation grading, with a coincidence rate of 94.8% (256/270). The difference in prognosis between patients with mild vascular compression and patients with severe vascular compression was statistically significant ( Z=-3.420, P=0.001), and the mean rank indicated that the prognosis of patients with severe vascular compression was better than that of patients with mild vascular compression (142.01 vs. 117.25). The prognosis difference between typical TN patients and atypical TN patients was statistically significant ( Z=-5.810, P=0.000), and the mean rank indicated that the prognosis of typical TN patients was better than that of atypical TN patients (144.45 vs. 97.08). Conclusions:Preoperative MR imaging evaluation is a reliable method to assess the degree of vascular compression. Patients with severe vascular compression and typical TN have high postoperative pain relief rate after MVD.
