PATHOLOGICAL FINDINGS ASSOCIATED WITH TRIGEMINAL NEURALGIA CAUSED BY VASCULAR COMPRESSION

被引:164
作者
HILTON, DA [1 ]
LOVE, S [1 ]
GRADIDGE, T [1 ]
COAKHAM, HB [1 ]
机构
[1] FRENCHAY HOSP,DEPT NEUROSURG,BRISTOL,AVON,ENGLAND
关键词
EPHAPTIC TRANSMISSION; PATHOLOGY; TRIGEMINAL NEURALGIA; VASCULAR COMPRESSION;
D O I
10.1227/00006123-199408000-00017
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
VASCULAR COMPRESSION OF the trigeminal nerve root accounts for more than 80% of intractable cases of trigeminal neuralgia, but the pathogenesis is still debated. The authors report the ultrastructural changes in the trigeminal nerve root of a patient with trigeminal neuralgia, at the point of compression by a large, medially placed petrosal vein, and compare these with the findings in six cases of trigeminal neuralgia not related to vascular compression. Vascular compression of the trigeminal nerve root was associated with focal loss of myelin and close apposition of the demyelinated axons with few intervening astrocytic processes. No inflammatory cells were present. Immunoelectron microscopy for glial fibrillary acid protein confirmed that astrocyte processes were largely confined to the periphery of the lesion. Of the other six rhizotomy specimens, only one, from a patient with multiple sclerosis, showed demyelination with intervening astrocyte processes, perivascular lymphocytes, and lipid-laden macrophages. These findings support the hypothesis that ephaptic transmission plays a role in the pathogenesis of trigeminal neuralgia related to vascular compression.
引用
收藏
页码:299 / 303
页数:5
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