[Microsurgical treatment of trigeminal neuralgia. A study of 50 cases]. / Traitement microchirurgical de la névralgie du trijumeau. Etude sur 50 cas.

The authors present a study of 50 patients with trigeminal neuralgia treated by posterior fossa microsurgery. Microvascular decompression of the trigeminal nerve was performed in 48 patients. In 2 cases no neuro-vascular compression was found, and a partial rhizotomy was carried out. In 98% of the cases there was postoperative abolition of the pain. Two cases of wound infection and three CSF fistulas were the operative complications. These patients were reoperated and cured. Twenty five patients were reviewed between 13 months and 8 years after surgery. Twenty one remained painfree without any drug, 3 were painfree taking 200 to 400 mg Carbamazepineper day, and 1 patient was reoperated after two years without pain because of recurrence of the neuralgia. There was no mortality or major morbidity in this series. Our results and the literature concerning this method are discussed in this article. In conclusion, microvascular decompression may be indicated in a large number of patients with essential trigeminal neuralgia due to its excellent pain control, no mortality and low morbidity.

[Perimesencephalic subarachnoid hemorrhage nonaneurysmatic: report of a case and literature review]. / Hemorragia subaracnóidea perimesencefálica não-aneurismática. Apresentação de caso e revisão de literatura.

A 42 year-old man with subarachnoid hemorrhage was admitted in our Service (Hunt & Hess grade II). CT-scan disclosed predominantly perimesencephalic subarachnoid hemorrhage. Digital subtraction angiographic study did not disclose either cerebral aneurysm or any other potential site of intracranial bleeding. The evolution was uneventful. A DSA was repeated one month later and was negative. Four months later, the patient was asymptomatic. The authors review the literature and emphasize the importance in recognizing this benign clinical form of nonaneurysmatic subarachnoid hemorrhage.

[Microsurgery of neurovascular decompression for trigeminal neuralgia: study of 35 cases]. / Microcirurgia de descompressão neuro-vascular para neuralgia do trigêmeo. Estudo de 35 casos.

The authors report the study of 35 cases of microvascular decompression for trigeminal neuralgia. No mortality and a very low morbidity were associated with this procedure. The choice of the treatment and the advantages of each method are discussed.