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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

3-D pre-operative evaluation of neurovascular conflict for trigeminal neuralgia using the Dextroscope platform

Meeting Abstract

  • corresponding author C. Serra - U.F. Neurochirurgia Stereotassica e Gamma Knife, Clinica Neurochirurgica, Università Vita-Salute, Milano, Italy
  • A. Falini - Servizio di Neuroradiologia IRCCS San Raffaele, Università Vita-Salute, Milano, Italy
  • A. Iadanza - Servizio di Neuroradiologia IRCCS San Raffaele, Università Vita-Salute, Milano, Italy
  • A. Franzin - U.F. Neurochirurgia Stereotassica e Gamma Knife, Clinica Neurochirurgica, Università Vita-Salute, Milano, Italy
  • P. Mortini - U.F. Neurochirurgia Stereotassica e Gamma Knife, Clinica Neurochirurgica, Università Vita-Salute, Milano, Italy
  • P. Picozzi - U.F. Neurochirurgia Stereotassica e Gamma Knife, Clinica Neurochirurgica, Università Vita-Salute, Milano, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 082

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc350.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Serra et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: 3-D virtual reality enviroments may help to pre-operatively simulate surgical procedures. These feature can be particularly useful for the pre-operative evaluation of neurovascular conflicts in the ponto-cerebellar region. Aim of the study is to compare pre-operative 3-D reconstructions with Dextroscope (DX) platform of neurovascular conflict in typical trigeminal neuralgia (TTN) with the findings obtained with common 2-D imaging methods and with the intraoperative findings.

Methods: Three patients with TTN underwent microvascular decompression (MVD). Before surgery the following. MRI sequences with a magnetic field of 3T were performed: T2-3D Drive, T1-3D CE-MR Angiography with contrast media (Vasovist) and T1-MPRAGE. MRI sequences were then loaded onto the Dextroscope (DX) platform and 3-D reconstruction of the neurovascular conflict was performed according to different planes, including surgical view. Intraoperative findings were then compared to those obtained on the DX and those following common neuroradiological evaluation.

Results: DX evaluation showed the presence of neurovascular conflict in all three cases. The descending loop of the superior cerebellar artery (SCA) was responsible of the conflict in all three cases. These findings were in complete accordance with surgery not only for what concerned the presence of the conflict but also for the exact spatial neurovascular relationships, the naming of the causative vessels and the simulation of the surgical approach. Neuroradiological evaluation indicated the absence of conflict in one cases and the presence of the conflict in the remaings but could not precisely name the vessels.

Conclusions: 3-D preoperative visualization of neurovascular conflict with Dextroscope allows a detailed description of the anatomic structures and relationships between vessels and nerves. It may help for the ethiologic acknowledgement of the causative vessel and for the accurate description of the modalithies of vascular compression (ie: direction and entity of impact) and therefore for the surgical planning.