Journal of neurosurgery
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The intracranial vertebral artery and its branches are a common site of aneurysms in the posterior fossa. Ninety-four aneurysms in 86 patients were analyzed for their clinical manifestation, diagnosis, and treatment. There were three distinct varieties of aneurysm in this group: 56 (60%) saccular aneurysms, 26 (28%) dissecting aneurysms, and 12 (13%) atherosclerotic fusiform aneurysms. ⋯ The dissecting aneurysms were characterized by a "narrowed segment" proximal and/or distal to a "fusiform dilatation" of the affected artery and by the presence of contrast medium in the intramural false lumen until the late phase. Poor postoperative outcome and the lateral medullary syndrome were seen only in dissecting aneurysms. Small atherosclerotic fusiform aneurysms seemed to be benign lesions that do not require any surgical treatment.
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Journal of neurosurgery · Sep 1988
Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia.
Sixty patients with trigeminal neuralgia or atypical facial pain were followed for an average of 1 year after percutaneous retrogasserian glycerol rhizolysis. The procedure was initially effective in relieving pain in 80% of the patients with typical trigeminal neuralgia and symptomatic trigeminal neuralgia secondary to multiple sclerosis. However, life-table analysis indicated that 50% of this group had persistence or recurrence of pain within 18 months after the operation. ⋯ Minor complications occurred in 23% of patients, and major morbidity was seen in 1.6%. Facial sensory loss which persisted for more than 1 month was found in 72% of patients, corneal hypesthesia occurred in 15%, and an additional 7% had corneal anesthesia. The data indicate that the success of percutaneous retrogasserian glycerol rhizolysis in relieving trigeminal neuralgia is directly related to the production of facial sensory loss.