RESUMO
Trigeminal neuralgia (TN) is characterized by sudden, brief intense pain in the distribution of the unilateral trigeminal nerve (TGN). Neurovascular compression (NVC) of the TGN is the most common cause of TN. Recent studies have suggested that a structural anomaly of the posterior cranial fossa might be involved in the development of TN, and several studies have documented the association between NVC-related TN and congenital posterior cranial deformities in adults. We present the case of a 56-year-old woman with NVC-related TN and unilateral lambdoid synostosis (ULS), along with a literature review, to investigate the relationship between TN and structural anomalies of the posterior fossa. This is the first report of TN in an adult with ULS. Mild and asymptomatic cases of lambdoid synostosis might have a higher incidence of NVC-related TN in association with posterior cranial fossa deformities.
RESUMO
PURPOSE: Lambdoid synostosis can be found unilaterally, bilaterally or in combination with other forms of craniosynostosis. Based on concept of frontoorbital advancement, we used the technique of occipital advancement in order to correct lambdoid synostosis MATERIAL & METHOD: From 2002 to 2006, standardized occipital bandeau advancement with barrel stave osteotomy was performed in two children who had multiple synostosis. The surgery was carried out for patients 12 & 18 months of age. RESULTS: Aesthetically satisfactory skull shape and normalization of the intracranial pressure could be achieved. A major complication in the form of life-threatening intraoperative hemorrhage and other complications such as infection have not occurred. CONCLUSION: Standardized occipital Bandeau advancement with barrel stave osteotomy allows precise, reproducible and predictable positioning of the segments. Artificial sutures are created as a result of the osteotomy. Remodeling leads to a well-proportioned skull shape and posterior advancement leads to an increase in intracranial volume.
Assuntos
Criança , Humanos , Craniossinostoses , Hemorragia , Pressão Intracraniana , Osteotomia , Crânio , Suturas , SinostoseRESUMO
Immobilization of unilateral (right) lambdoid suture was produced in 9-day-old rabbits to determine its effect on subsequent craniofacial growth. The suture was immobilized by the topical application of methyl-2-cyanoacrylate adhesive, subsequent growth effects on the cranial vault, cranial base and facial skeleton were assessed by serial radiographic cephalometry. The statistically significant result(p < 0.05) were: 1. The growth of immobilized lambdoid suture was decreased accompanying compensatory growth at coronal suture bilaterally. 2. The length of anterior and posterior cranial base was increased. 3. Anterior midfacial height was increased. 4. Lower midfacial angle (angular relationship of cranial base to lower midface) was decreased. With the view of above findings, it is clear that restricted growth was seen at unilateral lambdoid suture accompanying compensatory growth at coronal suture and resulted in altered cranial base and facial growth.