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Первостепенное тригеминальное стимулирование Ганлиона как метод лечения анестезии Долоросы: доклад по делу.

Анестезия долороса (AD) представляет собой редкий, изнуряющий вид боли в глухонемой среде с частотой от 0,3% до 2%, которая, как правило, является результатом иатрогенического повреждения тригеминального нерва, например после тригеминальной ризотомии. Как хроническое и изнурительное обезболивающие расстройство, которое часто отличается от фармакологического лечения, для улучшения результатов лечения необходимы различные подходы. По мере развития методов нейромодулирования в качестве потенциального терапевтического варианта для этого изнурительного состояния возникла прямая стимуляция тригемина

Совпадение в аннотации оригинала
BACKGROUND AND IMPORTANCE: Anesthesia dolorosa (AD) is a rare, debilitating type of deafferentation pain, with an incidence between 0.3% and 2%, typically resulting from iatrogenic injury to the trigeminal nerve, such as after trigeminal rhizotomy. As a chronic and debilitating pain disorder that is often refractory to pharmacological treatments, different a…

Peripheral neurotomy for torticollis: a new approach.

Most of spasmodic torticollis is classifical as cervical dystonia and the treatment of choice is chemical or surgical denervation. There are two major procedures for surgical denervation, intradural ventral rhizotomy and extradural peripheral neurotomy (Bertrand procedure). Both have advantages and disadvantages. The authors have modified these procedures to minimize the complications, with unilateral intradural ventral rhizotomy of C1 and C2, extradural denervation of the C3-C6 posterior rami, and contralateral peripheral sectioning of the branches of the spinal accessory nerve to the sternoc…

[Electrophysiological mapping of the trigeminal nerve root during microvascular decompression for trigeminal neuralgia].

A method for intraoperative electrophysiological mapping of the intracranial root of the trigeminal nerve was studied in five patients with … onse. This neural mapping was used during microvascular decompression in four patients and during a rhizotomy procedure in one patient. As a result of mapping, the fibers of the trigeminal division subserving the pain were clearly confirmed to be compressed by the artery in all four patients who were undergoing microvascular decompression. Likewise, the ant …

Sensory denervation of the kidney attenuates renovascular hypertension in the rat.

To determine the role of the renal afferent nerves in the pathogenesis of one-kidney, one-clip renovascular hypertension, the renal afferent nerves were selectively lesioned by dorsal rhizotomy, a procedure that eliminates renal sensory input to the spinal cord but does not directly damage the sympathomotor innervation of the kidney. One week after denervation, the proximal left renal artery was clipped in denervated and sham control rats. Blood pressure of the sham group rose progressively over the next 5 wk, to 185 mmHg (systolic). In contrast, blood pressure of the denervated rats leveled o…

Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery.

A patient with trigeminal neuralgia caused by direct compression by an elongated basilar artery of the 5th nerve at the zone of entry of its sensory root into the pons is presented. Rhizotomy of the portio major is a treatment of choice in such a case instead of simple microsurgical decompression. The elongated basilar artery is very firm and not readily movable with manipulation.

Thoracic Spinal Arachnoid Cyst in a Patient With Cerebral Palsy: Clinical Evaluation and Technical Note.

Spinal arachnoid cysts (SACs) are uncommon lesions that may lead to neurological decline due to spinal cord compression. They are particularly rare in the pediatric population and even more so among patients with cerebral palsy (CP). We present a case of a four-year-old female with CP undergoing evaluation for spasticity in the context of potential candidacy for selective dorsal rhizotomy. Imaging revealed a dorsal thoracic SAC extending from the level of T4 to T9, causing significant spinal cord compression. Given that differentiating spasticity-associated symptoms attributable to CP versus t…

Neurophysiological mechanisms of hypertonia and hypotonia in children with spastic cerebral palsy: surgical implications.

Mechanism of hypertonia in cerebral palsy children is dual: a neural component due to spasticity (velocity dependent) and a biomechanical component linked to soft tissue changes. Their differentiation-which might be clinically difficult-is however crucial, as only the first component will respond to anti-spastic treatments, the second to physiotherapy. Furthermore, spasticity is frequently associated with dystonia, which is a sustained hypertonic state induced by attempts at voluntary motion. Spasticity and dystonia have to be carefully distinguished as dorsal rhizotomy will not significantly …

Anatomic Study of Extracranial Needle Trajectory Using Hartel Technique for Percutaneous Treatment of Trigeminal Neuralgia.

OBJECTIVE: The aim of this study was to describe the anatomic trajectory of the extracranial needle for percutaneous rhizotomy and correlate this with structures at risk during such a procedure. METHODS: Six sides from 3 frozen fresh Caucasian heads were used in this study. Hartel anatomic landmarks for percutaneous trigeminal rhizotomy procedures were used. A free hand technique was then used, and intraprocedural visualization of the needle was performed with fluoroscopy. When the procedure was completed, the face was dissected along with the needle pathway up to the foramen ovale in order t…

Neuromodulation through sacral nerve roots 2 to 4 with a Finetech-Brindley sacral posterior and anterior root stimulator.

STUDY DESIGN: Investigation of five patients receiving an implant, using laboratory cystometry and self-catheterisation at home. OBJECTIVES: To use the established Finetech-Brindley sacral root stimulator to increase bladder capacity by neuromodulation, eliminating the need for posterior rhizotomy, as well as achieving bladder emptying by neurostimulation. SETTING: Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. METHODS: Five patients underwent implantation of a Finetech-Brindley stimulator without rhizotomy of the posterior roots. This was either a two c…

A Clinical Analysis of Secondary Surgery in Trigeminal Neuralgia Patients Who Failed Prior Treatment.

OBJECTIVE: Although many treatment modalities have been introduced for trigeminal neuralgia (TN), the long-term clinical results remain unsa … pression (MVD), gamma knife radiosurgery (GKRS), and percutaneous procedures such as radiofrequency rhizotomy (RFR), balloon compression, and glycerol rhizotomy (GR). The mean follow-up period was 69.9 months (range : 16-173). The mean interval between the prior treatment and second surgery was 26 months (range : 7-123). We evaluated the surgical outcomes u …

The Importance of Trigeminal Cisternography in the Percutaneous Treatment of Idiopathic Trigeminal Neuralgia.

Objective: To investigate whether the tip of the spinal needle was accurately positioned within the trigeminal cistern (TC) in patients with idiopathic trigeminal neuralgia undergoing percutaneous treatments through the foramen ovale. Methods: Transovale trigeminal cisternography (TOTC) was performed to ascertain the location of the spinal needle tip within the TC in 35 patients who underwent percutaneous retrogasserian glycerol rhizotomy (PRGR) procedures and 112 patients who underwent percutaneous controlled radiofrequency trigeminal rhizotomy (PCRF-TR) where the preganglionic trigeminal roo…

Neurosurgical treatment of multiple sclerosis.

OBJECTIVES: To describe the role of neurosurgical techniques in treatment of symptoms of multiple sclerosis (MS). METHODS: A review of the existing world literature searching (using PubMed, August 22, 2005) for key words 'multiple sclerosis' and multiple symptoms associated with MS including trigeminal neuralgia, pain (pump and rhizotomy), spasticity, intrathecal pump, hydrocephalus and stimulation (brain and spinal). RESULTS: In total, 1,404 articles met selection criteria. These were narrowed based upon uniqueness of technique described, nature of information provided and avoidance of redu…

An implantable neuroprosthesis for restoring bladder and bowel control to patients with spinal cord injuries: a multicenter trial.

OBJECTIVE: To evaluate the safety and efficacy of an implanted neuroprosthesis for management of the neurogenic bladder and bowel in individuals with spinal cord injury (SCI). DESIGN: Prospective study comparing bladder and bowel control before and at 3, 6, and 12 months after implantation of the neuroprosthesis. SETTING: Six US hospitals specializing in treatment of SCI. PATIENTS: Twenty-three neurologically stable patients with complete suprasacral SCIs. INTERVENTION: Implantation of an externally controlled neuroprosthesis for stimulating the sacral nerves and posterior sacral rhizotomy…

Inspiratory augmentation during asphyxic hyperpnoea and gasping: proprioceptive influences.

The relative inspiratory augmentations of sternomastoid, scalene, external intercostal, interchondral and diaphragmatic electromyographic ac … of inspiratory activity during the asphyxic hyperpnoea but did not abolish these relations. Dorsal rhizotomy at levels appropriate for the respective recording sites significantly limited the intercostal and interchondral augmentations, and depressed diaphragmatic activity to a less pronounced extent, but did not affect scalene activity. The asphyxic apnoe …

The influence of urethral position on urinary continence.

Bladder and urethral pressure responses to increasing intraabdominal pressure were studied in anesthetized cats. The results indicate that urethral responses are entirely passive and dependent on the intraabdominal position of the urethra. Urethral resistence to urine flow was not influenced by curare administration or complete sacral rhizotomy but was markedly decreased by phentolamine administration or the application of pressure directly to the bladder.

Trigeminal neuralgia: a personal review and nursing implications.

The facial pain of trigeminal neuralgia, also known as tic douloureux, has been described as the most excruciating pain known to man. The etiology of this disease is unknown, although some contributing factors have been identified. Medical treatment includes carbamazepine and other medications. Surgical options are microvascular decompression, percutaneous radiofrequency rhizotomy, balloon gangliolysis and temporary nerve lesions.

[Neurosurgical therapy of facial neuralgias].

INTRODUCTION: Neuralgias of the face, especially trigeminal neuralgia and glossopharyngeal neuralgia are indications for surgical interventi … mies were further analyzed. There was a 50% risk for pain recurrence two years after radiofrequency rhizotomy. On the other hand 64% of patients who underwent microvascular decompression remained painfree 20 years postoperatively. Patients with microvascular decompression without sensory deficit were painfree significantly longer than patients with postoper …

Neurostimulation in neurogenic patients.

PURPOSE OF REVIEW: To provide an overview of available electrical stimulation devices in neurogenic patients with lower urinary tract diseas … e already. The Brindley procedure (including sacral anterior root stimulation in combination with a rhizotomy of posterior sacral roots) is developed for selected spinal cord injury patient with a complete spinal injury, and has shown results for many years in neurogenic patients. An alternative to the rhizotomy is not established yet. SNM and PTNS are othe …

[Neurosurgical treatments for pain].

Pain represents the most frequent symptom faced by general practitioners and is associated with 60% of neurological troubles. Pain consists in a conscious, subjective, unpleasant and protective sensory experience transmitted by thermoalgic pathways in the central nervous system (nociceptive pain). Lesioning of peripheral or central sensory pathways can also generate pain associated with hypoesthesia (phantom or neuropathic pain). Since the 1920's, neurosurgeons have attempted to alleviate nociceptive and neuropathic chronic pain by interrupting (irreversible interruptive techniques) thermoalgi