资源描述：
《三叉神经痛和微血管减压ppt课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、TrigeminalNeuralgiaandMicrovascularDecompressionLiuZhan,Departmentofneurosurgery，2ndAffiliatedHospital1.DefinitionofTrigeminalNeuralgiaTrigeminalneuralgia (TN,or TGN),alsoknownas prosopalgia, suicidedisease,or Fothergill'sdisease, isa neuropathic disordercharacterizedbyepisodesof
2、intense painintheface,originatingfromthe trigeminalnerve.2.PrevalenceandIncidence2.1150,000peoplearediagnosedwithTNeveryyear（annualoccurrenceis3-5/100,000)2.2Overtheageof50(52-69).2.3Morecommoninwomenthaninmen（F/M，1.74/1).3.EtiologyofTNTN(EtiologicPoint)IdiopathicTN(MVC80%,AT,et)
3、SymptomaticTN(MS1.7-5%,Tumors0.8-11.6%)4.PathologyofTN4.1TNisakindofnon-nociceptivepain,whichiscausedbycompressionordamagetonervesinsteadofstimulationtoalgesiroreceptor.4.2PeripheralandcentraltheoryofTN:MVC,demyelination,ectopicimpulseintrigeminalnerve,sensoryreflexepilepsy,etc.5
4、.ClinicalcharactersofTN5.1DermatomeofTNTheophthalmicbranch(V1)isresponsibleforsensationfromthescalp,forehead,uppereyelidandtipofthenose.Themaxillarybranch(V2)sensationcoversthelowereyelid,thesideofthenose,theupperlipandcheek,andtheupperteethandgums.Themandibularbranch(V3)isrespon
5、sibleforsensationofthelowerteethandgums,lowerlip,chin,jaw,andpartoftheear.Itisalsoresponsibleforsupplyingthemusclesinvolvedwithchewing(mastication),thosemusclesinvolvedwithchewing.5.2MajorclinicalfeaturesofTNTN(SymptomaticViewpoint)TypicalTN(ParoxysmalPain)AtypicalTN(Paroxysmalan
6、dConstantPain)5.3DiagnosticcriteriaofTN(FromHIS):5.4DifferentDiagnosisofFacialPainGeneralcausesoforofacialpainGeneralprinciplesinthemedicalmanagementoffacialpain.TCAs,tricyclicantidepressants.6.TreatmentforTN6.1MedicalTreatment：6.1.1Carbamazapineisthegoldstandardforinitialtreatme
7、nt.6.3OperationforTN:6.3.1Percutaneousprocedures:Radiofrequencythermal;Glycerolinjection;Microcompression;6.3.2OpenSurgery(MVD):6.3.2.1TheoreticalBasis:6.3.2.2Preoperativeevaluation:3DMRI:3Dtimeofflight(3D-TOF),3Dconstructiveinterferenceinsteady–state(3D-CISS),fastimagingemployin
8、gsteady-stateacquisition(FIESTA).In3D-TO
