The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Koichi Iwasaki - One of the best experts on this subject based on the ideXlab platform.

  • a perforating artery compressing the nerve rootlet and causing Glossopharyngeal Neuralgia
    Neurosurgery, 2015
    Co-Authors: Naokado Ikeda, Hiroki Toda, Misaki Yamamoto, Shinichi Kanemaru, Masatsune Ishikawa, Koichi Iwasaki
    Abstract:

    BACKGROUND A surgical procedure for Glossopharyngeal Neuralgia (GPN) was selected from microvascular decompression, Glossopharyngeal and upper vagal rhizotomy, or a combination of these procedures based on the presence of arteries compressing the Glossopharyngeal and vagal rootlets. The offending artery is usually a main trunk or branch of the cerebellar arteries. A perforating artery is a known but uncommon variation of the offending artery that causes GPN. The appropriate procedure for such cases is unknown. OBJECTIVE To analyze the clinical significance of the perforating artery in GPN, we describe 2 patients with a perforating artery compressing the rootlet, and its mobilization relieved Neuralgia. We examined the validity of decompressing a perforating artery as an alternative to rhizotomy in such cases. METHODS We independently reviewed 12 GPN patients treated with microvascular decompression. The patients' pain severity, medication doses, preoperative imaging studies, intraoperative findings, and outcomes were examined. RESULTS Eleven patients had neurovascular compression of the Glossopharyngeal nerve. In 2 of the patients, a perforating artery compressed the rootlet, thereby generating an indentation and creating a discoloration of the rootlet. Mobilizing the perforating artery with no additional rhizotomy provided complete pain relief with no significant complications and allowed the discontinuation of medications. CONCLUSION Even a small perforating artery can cause GPN when it compresses the rootlet. In such cases, mobilization of the perforating artery with no additional rhizotomy is an effective surgical option.

  • combined hyperactive dysfunction syndrome of the cranial nerves trigeminal Neuralgia hemifacial spasm and Glossopharyngeal Neuralgia 11 year experience and review
    Neurosurgery, 1998
    Co-Authors: Hitoshi Kobata, Akinori Kondo, Koichi Iwasaki, Tatsuya Nishioka
    Abstract:

    Objective A pathological condition caused by vascular compression at the root entry/exit zone of the cranial nerves is designated hyperactive dysfunction syndrome (HDS) of the cranial nerves. Patients with HDS who exhibited a combination of trigeminal Neuralgia (TN), hemifacial spasm (HFS), and/or Glossopharyngeal Neuralgia were retrospectively reviewed, to study the incidence, etiological factors, and demographic characteristics for this combined HDS group. Methods Medical and surgical records were analyzed for 41 patients with combined HDS, of 1472 consecutive patients with HDS who were treated between 1984 and 1994. Results The combined HDS group accounted for 2.8% of all patients with HDS; 19 patients (1.3%) exhibited bilateral symptoms, i.e., 14 cases of TN, 3 of combined TN and HFS, and 2 of HFS. Twenty-two patients (1.5%) exhibited ipsilateral symptoms, i.e., 19 cases of TN and HFS and 3 of TN and Glossopharyngeal Neuralgia. Excluding three patients whose symptoms were associated with brain tumors or arteriovenous malformations, this patient group was older (63.2 versus 55.3 yr, P = 0.0009) and exhibited an increased percentage of associated hypertension (47.4 versus 17.5%, P = 0.000008), with a female predominance (86.8 versus 71.3%, P = 0.07), compared with the single HDS group. Thirty-six of these patients underwent a total of 61 microvascular decompression procedures, with favorable outcomes. The offending vessels were similar to those in single HDS, which were usually conventional and multiple. Conclusion The associated etiological factors for vascular compression syndromes were more evident in the combined HDS group than in the single HDS group. Progressive arteriosclerotic vasculoarchitectural changes of the vertebrobasilar system, accelerated by aging and hypertension, bring about the development of combined HDS, with a remarkable female predominance.

Carvalho,deusvenir De Souza - One of the best experts on this subject based on the ideXlab platform.

  • Glossopharyngeal Neuralgia with syncope as a sign of neck cancer recurrence
    Academia Brasileira de Neurologia - ABNEURO, 2007
    Co-Authors: Ribeiro,reinaldo Teixeira, Nilton Amorim De ,souza, Carvalho,deusvenir De Souza
    Abstract:

    Glossopharyngeal Neuralgia with syncope as a sign of neck cancer is a very rare condition. A review of the literature revealed only 29 cases formerly reported. We present the first Brazilian case of such association. A 68-year-old man presented with paroxysmal excruciating pain over the right side of the neck, sometimes followed by syncope. Given the suspicion of recurrent tumor from a previously treated neck malignancy, a computed tomography scan was performed and a right parapharyngeal tumor was shown. Pain and syncope were successfully controlled with carbamazepine and the patient underwent palliative radiotherapy

  • Neuralgia glossofaríngea com síncope como um sinal de recidiva de câncer do pescoço
    'FapUNIFESP (SciELO)', 2007
    Co-Authors: Ribeiro,reinaldo Teixeira, Nilton Amorim De ,souza, Carvalho,deusvenir De Souza
    Abstract:

    Glossopharyngeal Neuralgia with syncope as a sign of neck cancer is a very rare condition. A review of the literature revealed only 29 cases formerly reported. We present the first Brazilian case of such association. A 68-year-old man presented with paroxysmal excruciating pain over the right side of the neck, sometimes followed by syncope. Given the suspicion of recurrent tumor from a previously treated neck malignancy, a computed tomography scan was performed and a right parapharyngeal tumor was shown. Pain and syncope were successfully controlled with carbamazepine and the patient underwent palliative radiotherapy.Neuralgia glossofaríngea com síncope como um sinal de câncer do pescoço é uma condição muito rara. Uma revisão da literatura revelou apenas 29 casos relatados anteriormente. Apresentamos o primeiro caso brasileiro de tal associação. Um homem de 68 anos se apresentou com dores paroxísticas insuportáveis no lado direito do pescoço, algumas vezes seguidas de síncope. Dada a suspeita de recidiva tumoral derivada de uma malignidade cervical tratada previamente, realizou-se um exame de tomografia computadorizada que evidenciou um tumor parafaríngeo direito. As dores e as síncopes foram controladas satisfatoriamente com carbamazepina e o paciente foi submetido à radioterapia paliativa.Federal University of São Paulo Department of NeurologyUNIFESP, Department of NeurologySciEL

Yuanjie Zeng - One of the best experts on this subject based on the ideXlab platform.

R Naraghi - One of the best experts on this subject based on the ideXlab platform.

  • DOI 10.1007/s10194-011-0349-x ORIGINAL
    2013
    Co-Authors: C Gaul, P Hastreiter, A Duncker, R Naraghi
    Abstract:

    Diagnosis and neurosurgical treatment of Glossopharyngeal Neuralgia: clinical findings and 3-D visualization of neurovascular compression in 19 consecutive patient

  • Diagnosis and neurosurgical treatment of Glossopharyngeal Neuralgia: clinical findings and 3-D visualization of neurovascular compression in 19 consecutive patients
    The Journal of Headache and Pain, 2011
    Co-Authors: C Gaul, P Hastreiter, A Duncker, R Naraghi
    Abstract:

    Glossopharyngeal Neuralgia is a rare condition with neuralgic sharp pain in the pharyngeal and auricular region. Classical Glossopharyngeal Neuralgia is caused by neurovascular compression at the root entry zone of the nerve. Regarding the rare occurrence of Glossopharyngeal Neuralgia, we report clinical data and magnetic resonance imaging (MRI) findings in a case series of 19 patients, of whom 18 underwent surgery. Two patients additionally suffered from trigeminal Neuralgia and three from additional symptomatic vagal nerve compression. In all patients, ipsilateral neurovascular compression syndrome of the IX cranial nerve could be shown by high-resolution MRI and image processing, which was confirmed intraoperatively. Additional neurovascular compression of the V cranial nerve was shown in patients suffering from trigeminal Neuralgia. Vagal nerve neurovascular compression could be seen in all patients during surgery. Sixteen patients were completely pain free after surgery without need of anticonvulsant treatment. As a consequence of the operation, two patients suffered from transient cerebrospinal fluid hypersecretion as a reaction to Teflon implants. One patient suffered postoperatively from deep vein thrombosis and pulmonary embolism. Six patients showed transient cranial nerve dysfunctions (difficulties in swallowing, vocal cord paresis), but all recovered within 1 week. One patient complained of a gnawing and burning pain in the cervical area. Microvascular decompression is a second-line treatment after failure of standard medical treatment with high success in Glossopharyngeal Neuralgia. High-resolution MRI and 3D visualization of the brainstem and accompanying vessels as well as the cranial nerves is helpful in identifying neurovascular compression before microvascular decompression procedure.

Pietro Mortini - One of the best experts on this subject based on the ideXlab platform.

  • The emerging role of gamma knife radiosurgery in the management of Glossopharyngeal Neuralgia
    Neurosurgical review, 2017
    Co-Authors: Alfio Spina, Nicola Boari, Filippo Gagliardi, Michele Bailo, Carlotta Morselli, Sandro Iannaccone, Pietro Mortini
    Abstract:

    Glossopharyngeal Neuralgia (GPN) represents a rare craniofacial disorder accounting for about 1% of all craniofacial pain syndromes. GPN shares several pathophysiologic and clinical features with the more common trigeminal Neuralgia. Medical therapy and microvascular decompression, in case of vascular nerve compression, represented the mainstay of GPN management. Other ablative therapies have been reported to date; however, few data are available because of the rarity of this pain syndrome. Among the ablative procedures, gamma knife radiosurgery (GKRS) has been recently introduced in the management of GPN with good pain control and low complication rates. Authors performed a systematic review of the published literature about GKRS in the management of GPN. Radiosurgical treatment data, pain control and recurrence rate have been analysed and compared. GKRS represented a valuable and effective treatment option for the management of GPN. Pain control and complication rates are better than those reported by other ablative procedures and microvascular decompression; however, future studies should be focused on the long-term efficacy of GKRS.