gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Intraoperative ICG angiography in microvascular decompression procedures for trigeminal neuralgia.

Meeting Abstract

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  • K.V. Eckardstein - Klinik für Neurochirurgie, Universitätsmedizin Göttingen
  • V. Rohde - Klinik für Neurochirurgie, Universitätsmedizin Göttingen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 053

DOI: 10.3205/12dgnc440, URN: urn:nbn:de:0183-12dgnc4405

Published: June 4, 2012

© 2012 Eckardstein et al.
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Outline

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Objective: In microvascular decompression procedures of the trigeminal nerve for trigeminal neuralgia occasionally the site of contact is difficult to determine. Endoscopy was described by others to better evaluate the anatomical conflict. ICG-angiography can also be used to better visualize vascular structures and their anatomical relation with cranial nerves. We sought to evaluate our initial experience in this respect.

Methods: We reviewed the video recordings of seven cases of trigeminal neuralgia microvascular decompression operations and assessed visualization of neurovascular structures. We focused on whether ICG-angiography was helpful in determining the site conflict and whether fluorescence was strong enough to shine through the cranial nerves obliterating the direct view of the respective vessel.

Results: A standard retrosigmoid approach in the supine position was used for the decompression procedure. Fluorescence is not powerful enough to visualize vessel loops hidden behind cranial nerves, a shine through only on the very lateral aspect of nerves and with very thin structures. However, we found ICG angiography helpful in appreciating the individual, sometimes distorted anatomy of the cerebello-pontine angle.

Conclusions: Although our initial hope and expectation did not prove true, that ICG-angiography makes it possible to “see through nerves” that obliterate visualization of offending vessels, we found this technique useful to quicker understand the individual complexity of the anatomy of the cerebello-pontine angle.