[Preoperative enhanced three-dimensional spoiled gradient-recalled imaging for microvascular decompression of trigeminal neuralgia].

OBJECTIVE: To study the preoperative high resolution three-dimensional MR imaging of idiopathic trigeminal neuralgia, demonstrating the use in selection of patients and planning of the treatment. METHODS: The enhanced three-dimensional spoiled gradient-recalled imaging and three-dimensional MR angiography with 3-T MRI system were used to detect the anatomic relationship of neural and vascular structures at the trigeminal root entry zone preoperatively, surgical findings served as a reference to compare the MR visualization with the exact anatomic relations. RESULTS: Twenty-nine of 33 patients, who had the MRI positive vascular contact or compression, which was consistent to the symptom side, received the microvascular decompression (MVD). Surgical findings revealed neurovascular conflicts in all subjects, 27 of 29 (93%) were consistent to the imaging results, all the patients treated with MVD had the immediate complete pain relief. CONCLUSIONS: High-resolution MR imaging successfully demonstrated its usefulness in detecting the neurovascular contact at the trigeminal root entry zone, thereby facilitating the selection of patients who were most likely to benefit from MVD.

Traumatic subdural hydroma developing into chronic subdural hematoma.

OBJECTIVE: To probe the incidence, pathogenesis and clinical characteristics of traumatic subdural hydroma (TSH) developing into chronic subdural hematoma (CSDH). METHODS: We retrospectively analyzed the clinical data of 32 patients with TSH developing into CSDH and reviewed related literature. RESULTS: 16.7% of TSH developed into CSDH in this study. The time of evolution was from 22 to 100 days after head injury. All the patients were cured with hematoma drainage. CONCLUSIONS: TSH is one of the origins of CSDH. The clinical characteristics of TSH developing into CSDH follow that the ages of the patients are polarized, that the evolution often happens in the patients with small chronic hydromas and being treated conservatively, that the patients are usually injured deceleratedly and that the accompanying cerebral damage is often very mild.

[Diagnosis and treatment of cystic acoustic neuroma].

OBJECTIVE: To study the clinical features and treatment of cystic acoustic neuroma. METHODS: Twenty-two patients with cystic acoustic neuromas were diagnosed by CT and MRI preoperatively, and the tumors were resected by retrosigmoid approach, and verified by pathological studies. RESULTS: Of the 22 patients, 18 had tumors totally resected (postoperative house Brackman facial nerve grading: grade II in 4 patients, III in 7, IV in 3, V in 2, VI in 2) and 4 had tumors subtotally resected. CONCLUSION: Because of its specific clinical features and poor operative results, cystic acoustic neuroma should be regarded as a specific subtype.