Microvascular decompression for treatment of trigeminal neuralgia and hemifacial spasm: clinical outcomes related to pre-operative magnetic resonance imaging

Abstract

Objective To investigate the role of preoperative three dimensional magnetic resonance imaging in predicting the clinical outcomes of microvascular decompression for the treatment of trigeminal neuralgia and hemifacial spasm.Methods Fifty-seven patients with trigeminal neuralgia and 18 with hemifacial spasm,admitted to our hospital from January 2008 to December 2012,were included in our study.All the patients were performed 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA) prior to microvascular decompression,and 6 of them also performed 3D fast imaging employing steady-state acquisition (3D-FIESTA) MRI.In all patients,the presence of vascular contact,offenders were determined by 3D-TOF-MRA and 3D-FIESTA MRI,and the preoperative findings were compared with the surgical findings and clinical outcomes.Results Between the symptomatic sides and asymptomatic sides,the difference of vascular contact manifested by MRI was statistically significant (P＜0.05).The coincidence of MR imaging and sight during the operation was similar.Conclusion Preoperative 3D-TOF-MRA and 3D-FIESTA can identify the relationship between the nerve and adjacent vessels in patients with trigeminal neuralgia or hemifacial spasm,which assists in preoperative planning and improve the operation effect. Key words: Trigeminal neuralgia; Hemifacial spasm; Microvascular decompression; Magnetic resonance angiography