Journal Information
Vol. 15. Issue 4.
Pages 345-351 (January 2004)
Share
Share
Download PDF
More article options
Vol. 15. Issue 4.
Pages 345-351 (January 2004)
Manejo de la recidiva de la neuralgia del trigémino tras descompresión microvascular
Management of recurrent trigeminal neuralgia after failed microvascular decompression
Visits
2741
C. Fernández-Carballal
, F. García-Salazar, J. Pérez-Calvo, R. García-Leal, F.A. Gutiérrez, R. Carrillo
Servicio de Neurocirugía. Hospital General Universitario Gregorio Marañón. Madrid
This item has received
Article information
Resumen
Objetivos

Evaluar el manejo terapéutico de los pacientes con recidiva del dolor trigeminal tras descompresión microvascular.

Material y métodos

Entre 1993 y 2002 se realizaron en nuestro servicio 60 exploraciones quirúrgicas de la fosa posterior para tratamiento de la neuralgia del trigémino. Se recogieron los datos de los pacientes que precisaron una nueva intervención quirúrgica por recidiva del dolor trigeminal, así como el tipo de intervención quirúrgica realizada, los hallazgos intraoperatorios en los casos de reexploración de la fosa posterior, y el pronóstico y las complicaciones que presentaron.

Resultados

En 18 pacientes se objetivó recidiva del dolor trigeminal y necesidad de un nuevo procedimiento quirúrgico, que consistió en una nueva exploración de la fosa posterior en 9 pacientes y ter-mocoagulación percutánea en 9 pacientes. En 7 de las 9 reexploraciones (77%) ésta fue negativa, realizándose rizotomía sensitiva parcial del tercio inferior de la raíz como procedimiento terapéutico. La mayoría de las termocoagulaciones (5 de 9) se realizaron en pacientes con edad avanzada o contraindicación médica para la realización de reexploración de fosa posterior.

Conclusiones

La reexploración de fosa posterior es un método eficaz en el tratamiento de la recidiva de la neuralgia del trigémino tras descompresión microvascular. En el caso de exploración negativa, la rizotomía sensitiva parcial es el método quirúrgico de elección.

Palabras clave:
Neuralgia del trigémino
Recidiva
Rizotomía sensitiva parcial
Reintervención
Summary
Objective

To evaluate the surgical management of patients with trigeminal neuralgia after failed micro-vascular decompression.

Patients and methods

Between 1993 and 2002, exploration of the posterior fossa was performed in 60 patients with trigeminal neuralgia. Records were analyzed retrospectively for those patients who needed another surgical procedure due to recurrence of pain, describing which procedure was performed, postoperative results and complications, and also the intraope-rative findings when posterior fossa reexploration was realized.

Results

Eighteen patients had trigeminal neuralgia recurrence requiring a new surgical intervention, that consisted in a fossa posterior reexploration in nine patients and percutaneous radiofrequency termal rhi-zotomy in the other nine patients. Among the repeat operations, there was negative exploration in 7 patients (77%), and a partial sensory rhizotomy was performed. Most of thermocoagulations (5/9) were performed in old patients or patients with anestesie contraindication for the fossa posterior reexploration.

Conclusion

Fossa posterior reexploration is an effective and safe surgical attitude in the treatment of recurrent trigeminal neuralgia after failed microvascular decompression. Partial sensory rhizotomy is recom-mended when the reexploration is negative.

Key words:
Trigeminal neuralgia
Recurrence
Partial sensory rhizotomy
Reoperation

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Neurocirugía (English edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?