Microvascular decompression for adolescent-onset cranial neuropathies

Abstract

Objective To analyze the epidemiology, pathogenesis, clinical features of adolescent-onset cranial neuropathies (ACN) and to discuss the surgical effects and complications of microvascular decompression (MVD). Methods We retrospectively analyzed 37 ACN patients (including 34 successfully followed up) who underwent MVD at Department of Neurosurgery, China-Japan Friendship Hospital from March 2001 to October 2016 (ACN group) and compared them with 210 cases of adult cranial neuropathies (CN) which included 188 successfully followed up and were extracted by random sampling method during the same period (adult CN group). Results The symptoms of 37 cases in ACN group were unilateral. The average age of onset was 16.7±1.5 years. Compared with the adult CN group, the rate of affecting the right side (56.7% vs. 41.0%), the ratio of arachnoid thickening in cerebellopontine angle (CPA) region (78.4% vs. 25.7%), the rate of narrow posterior fossa (54.0% vs. 28.6%) and incidence of acoustic complications (14.7% vs. 4.3%) were all higher in ACN group, which however demonstrated a lower rate of AICA oppression (24.3% vs. 42.8%). Those differences were statistically significant (all P 0.05). Conclusions ACN seems to be rare and more commonly affect the right side. Arachnoid thickening in CPA region and the small volume of posterior cranial fossa may be the pathogenic factors. MVD could be a safe and effective surgical method for ACN in which the operational efficiency is almost the same as that of adult CN, while the incidence of complications in ACN group is suggested to be higher than that in the group of adult CN. Key words: Cranial neuropathy; Microvascular decompression; Adolescent; Disease attributes