OBJECTIVE Precise assessment of the complex nerve-vessel relationship at the root entry zone of the trigeminal nerve is useful for planning microvascular decompression in patients with idiopathic trigeminal neuralgia. We have applied a fusion imaging technique of three-dimensional (3-D) magnetic resonance cisternography and co-registered 3-D magnetic resonance angiography (MRA) that allows virt...

BACKGROUND Microvascular decompression has been widely used as the first choice in treating trigeminal neuralgia, but in a few patients, facial pain cannot be effectively controlled by microvascular decompression. We sought to clarify the important factors for good operative outcomes. METHODS We reviewed 62 patients with trigeminal neuralgia treated by microvascular decompression during the p...

The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magneti...

An 80-year-old man presented with difficulty in swallowing and speaking which had progressed over one year. Neurological examination revealed right hypoglossal nerve palsy with ipsilateral atrophy (Picture A). Laryngoscopic examination was unremarkable. Slowly progressive dysarthria and dysphagia with tongue atrophy initially indicated motor neuron disease (MND), but needle electromyographic ex...

AIM Cerebrospinal fluid (CSF) leakage is a feared complication after microvascular decompression (MVD). In this study, we present our experience of fleece-bound tissue sealing in MVD with an aim to minimize the rate of postoperative CSF leakage. MATERIAL AND METHODS We treated 50 patients (female/male: 26/24) with neurovascular compression (NVC) syndromes (trigeminal neuralgia, hemifacial spa...

Background: Popliteal (Baker) cysts are enlarged gastrocnemius-semimembranosus bursae leading to swelling in the popliteal fossa. Surgical decompression and capsulectomy is definitive treatment for symptomatic with arthroscopic or open decompression. Arthroscopic minimally invasive, entails lower risks, allows earlier more aggressive rehabilitation compared excision. Indications: Indications cy...

Direct ventral access to the cervicothoracic spine (C7-T4) poses a technical challenge in spine surgery, given the vital neurovascular structures residing anterior to the cervicothoracic junction (CTJ). The transsternal approach is a feasible surgical option that allows for direct anterior exposure of the lower cervical and upper thoracic vertebrae. Here, the authors report a case of an elderly...

Background Microvascular decompression (MVD) is a non-ablative technique designed to resolve the neurovascular conflict responsible for typical idiopathic trigeminal neuralgia (TN). Method With the patient in a supine position, a small elliptical retrosigmoid craniectomy is used to approach the cerebellopontine angle and the trigeminal nerve. After careful exploration of the trigeminal root ent...

BACKGROUND Intermuscular approaches can expose the lumbar spine and minimize muscular trauma and injury. The segmental anatomy of the posterior lumbar musculature allows surgical access through separation of muscle groups and fascicles and provides one to develop intermuscular working channels while preserving the integrity of the muscles and their function. In addition, preservation of the acc...