Hemodynamic features of offending vessels at neurovascular contact in patients with trigeminal neuralgia and hemifacial spasm.
J Neurosurg
; : 1-7, 2018 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-29979116
ABSTRACT
OBJECTIVEOffending vessels at the site of neurovascular contact (NVC) in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS) may have specific hemodynamic features. The purpose of this study was to investigate the wall shear stress (WSS) of offending vessels at NVCs by conducting a computational fluid dynamics (CFD) analysis.METHODSThe authors retrospectively analyzed the cases of 20 patients (10 with TN and 10 with HFS) evaluated by 3D CT angiography and used the imaging findings for analysis of the hemodynamic parameters. The 3D CFD images were directly compared with the NVCs determined by simulated multifusion images of CT angiogram and MR cisternogram, and operative photos. The magnitudes of the WSS (WSSm) at the proximal (WSSm-p), just-beginning (WSSm-j), contact site (WSSm-s), and distal (WSSm-d) areas of each NVC were analyzed. The ratios of the WSSm-j, WSSm-s, and WSSm-d areas to the WSSm-p area were calculated individually. The direction of the WSS (WSSv) and its temporal variation (WSSvV) were depicted and morphologically compared with the NVC confirmed by simulated images and operative findings.RESULTSThe ratios of WSSm at the just-beginning and the contact site to the proximal area of the NVCs (WSSm-j/WSSm-p and WSSm-s/WSSm-p) were both significantly higher than that at the distal area (WSSm-d/WSSm-p) (p < 0.05). The WSSv and WSSvV at the NVCs showed small variation in a single cardiac cycle, especially along the areas that were in contact with the affected nerve.CONCLUSIONSAreas of relatively high WSSm and temporal variation of WSSm (WSSmV) were observed at the NVCs. Less mobility of the WSSv and WSSvV was detected along the side of the vessels in contact with the nerves. These findings may be consistent with the actual area of the NVC. Hemodynamic features of the site of NVC can be added to the preoperative simulation for MVD surgery, which may be useful for the diagnosis and treatment planning of TN and HFS.
AICA = anterior inferior cerebellar artery; CFD = computational fluid dynamics; FR-avg = time-averaged flow rate; HFS = hemifacial spasm; MVD = microvascular decompression; NVC = neurovascular contact; NVC-d = distal NVC area; NVC-j = just-beginning NVC area; NVC-p = proximal NVC area; NVC-s = contact site NVC area; PICA = posterior inferior cerebellar artery; SCA = superior cerebellar artery; TN = trigeminal neuralgia; WSS = wall shear stress; WSSm = magnitude of WSS; WSSm-avg = time-averaged WSSm; WSSm-d = WSSm at distal area of NVC; WSSm-dia = end-diastolic WSSm; WSSm-j = WSSm at just-beginning area of NVC; WSSm-p = WSSm at proximal area of NVC; WSSm-s = magnitude of WSS at contact site; WSSm-sys = peak-systolic WSSm; WSSmV = temporal variation of magnitude of WSS; WSSv = direction of WSS; WSSvV = temporal variation of direction of WSS; computational fluid dynamics; hemifacial spasm; neurovascular contact; pain; trigeminal neuralgia; wall shear stress
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article