Impressão basilar como causa de neuralgia do trigêmeo: registro de um caso

Silva, José Alberto Gonçalves da; Silva, Erasmo Barros da

doi:10.1590/S0004-282X1982000200006

Resumos

É referido um caso de impressão basilar sintomática com neuralgia do trigêmeo. O tratamento cirúrgico consistiu em craniectomia da fossa posterior e laminectomia cervical alta. No pós-operatório imediato houve remissão total dos paroxismos dolorosos.

A case of basilar impression associated with Arnold-Chiari malformation and with trigeminal neuralgia is reported. The radiological examination of the skull showed marked asymmetry of the petrous bone with the tip of the odontoid apophysis located 30 mm above the McGregor line. Treatment consisted of craniectomy of the posterior fossa and cervical laminetomy (Ca to C3). The postoperative course was uneventful with total disappearance of the trigeminal neuralgia.

Impressão basilar como causa de neuralgia do trigêmeo: registro de um caso

Basilar impression as a cause of trigeminal neuralgia: a case report

José Alberto Gonçalves da Silva^I; Erasmo Barros da Silva^II

^IProfessor de Clínica Neurocirúrgica. Centro de Ciências da Saúde da Universidade Federal da Paraíba

^IIProfessor Colaborador. Centro de Ciências da Saúde da Universidade Federal da Paraíba

RESUMO

É referido um caso de impressão basilar sintomática com neuralgia do trigêmeo. O tratamento cirúrgico consistiu em craniectomia da fossa posterior e laminectomia cervical alta. No pós-operatório imediato houve remissão total dos paroxismos dolorosos.

SUMMARY

A case of basilar impression associated with Arnold-Chiari malformation and with trigeminal neuralgia is reported. The radiological examination of the skull showed marked asymmetry of the petrous bone with the tip of the odontoid apophysis located 30 mm above the McGregor line.

Treatment consisted of craniectomy of the posterior fossa and cervical laminetomy (C_a to C₃). The postoperative course was uneventful with total disappearance of the trigeminal neuralgia.

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Full text available only in PDF format.

Hospital São Vicente de Paulo - 58000 João Pessoa, PB - Brasil.

1. BARRAQUER-BORDAS, L. - Síndromes neurológicos asociados a malformaciones óseas de la region del foramen magnum. Med. esp. 21:198, 1949.
2. BJERRUM, J. & THORNVAL, G. - Roentgenographic findings in trigeminal neuralgia. Acta radiol. 51:289, 1959.
3. CAETANO DE BARROS, M.; FARIAS, W.; ATAÍDE, L. & LINS, S. - Basilar impression and Arnold-Chiari malformation. J. Neurol. Neurosurg. Psychiat. (London) 31:596, 1968.
4. DANDY, W. E. - Concerning the cause of trigeminal neuralgia. Amer. Surg. 24:447, 1934.
5. DISTELMAIER, P. - Komplikationen der operativen neurochirurgischen Behan-dlung der Trigeminusneuralgie. Zbl. Neurochir. 37:119, 1976.
6. GARDNER, W. J.; TODD, E. M. & PORTUGAL PINTO, J. - Roentgenographic findings in trigeminal neuralgia. Amer. J. Roentgenol. 76:346, 1956.
7. JANNETTA, P. J. - Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J. Neurosurg. 26:159, 1967.
8. JANNETTA, P. J. - Microsurgical approach to the trigeminal nerve for tic douloureux. Prog, neurol. Surg. 7:180, 1976.
9. JANNETTA, P. J. - Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations. Clinical Neurosurgery, 24:538, 1977.
10. JANNETTA, P. J. - Observations on the etiology of trigeminal neuralgia, hemifacial spasm acoustic nerve dysfunction and glossopharyngeal neuralgia: definitive microsurgical treatment and results in 117 patients. Neurochirurgia 20:145, 1977.
11. JANNETTA, P. J. & ZORUB, D. S. - Microvascular Decompression for Trigeminal Neuralgia. Raven Press, New York, 1979, pág. 143.
12. JANNETTA, P. J. - Neurovascular compression in cranial nerve and systemic disease. Ann. Surg. 192:518, 1980.
13. KLAUS, E. - Die basilaere Impression. S. Hirzel, Leipzig, 1969.
14. MUELLER, H. R. & LEVY, A. - Zur Pathogenese der Trigeminusneuralgie. Acta Neurochir. 11:385, 1963.
15. OBRADOR, S. & BOIXADÔS, J. R. - Neuralgia del trigemino secundaria a impresion basilar y platibasia. Rev. clin. esp. 58:233, 1955.
16. OBRADOR, S.; QUEIMADELOS, V. G. & SOTO, M. - Trigeminal neuralgia secondary to asymmetry of the petrous bone: case report. J. Neurosurg. 33:596, 1970.
17. OLIVECRONA, H. - Die Trigeminusneuralgie und ihre Behandlung. Nervenarzt 14:49, 1941.
18. SATO, O.; KAN AZAWA, I. & KOKUNAI, T. - Trigeminal neuralgia caused by compression of trigeminal nerve by pontine vein. Surg. Neurol. 11:285, 1979.
19. SCHUELLER, A. - Zur Roentgen-Diagnose der basalen Impression des Schaedels. Wien. med. Wschr. 40:2594, 1911.
20. SPRUNG, H. B. - Beitrag zur Genese der idiopathischen Trigeminusneuralgie. Zbl. Neurochir. 13:284, 1953.
21. TAYLOR, A. R. & CHAKRAVORTY, B. C. - Clinical syndromes associated with basilar impression. Archs Neurol. (Chicago) 10:475, 1964.
22. WAGA, S.; MORIKAWA, A. & KOJIMA, T. - Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg. Neurol. 11:13, 1979.
23. WEBER, E. - Die Form der Schaedelbasis in ihrer Beziehung zum Gesichtsschmerz, speziell zur Trigeminusneuralgie. Acta Neurochir. Suppl. 3:72, 1955.
24. WEBER, E. - Zur Problematik der Trigeminus-Neuralgie. Nervenarzt 31:88, 1960.

Datas de Publicação

Publicação nesta coleção
16 Ago 2012
Data do Fascículo
Jun 1982

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BARRAQUER-BORDAS, L. - Síndromes neurológicos asociados a malformaciones óseas de la region del foramen magnum. Med. esp. 21:198, 1949.

[2] 2. BJERRUM, J. & THORNVAL, G. - Roentgenographic findings in trigeminal neuralgia. Acta radiol. 51:289, 1959.

[3] 3. CAETANO DE BARROS, M.; FARIAS, W.; ATAÍDE, L. & LINS, S. - Basilar impression and Arnold-Chiari malformation. J. Neurol. Neurosurg. Psychiat. (London) 31:596, 1968.

[4] 4. DANDY, W. E. - Concerning the cause of trigeminal neuralgia. Amer. Surg. 24:447, 1934.

[5] 5. DISTELMAIER, P. - Komplikationen der operativen neurochirurgischen Behan-dlung der Trigeminusneuralgie. Zbl. Neurochir. 37:119, 1976.

[6] 6. GARDNER, W. J.; TODD, E. M. & PORTUGAL PINTO, J. - Roentgenographic findings in trigeminal neuralgia. Amer. J. Roentgenol. 76:346, 1956.

[7] 7. JANNETTA, P. J. - Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J. Neurosurg. 26:159, 1967.

[8] 8. JANNETTA, P. J. - Microsurgical approach to the trigeminal nerve for tic douloureux. Prog, neurol. Surg. 7:180, 1976.

[9] 9. JANNETTA, P. J. - Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations. Clinical Neurosurgery, 24:538, 1977.

[10] 10. JANNETTA, P. J. - Observations on the etiology of trigeminal neuralgia, hemifacial spasm acoustic nerve dysfunction and glossopharyngeal neuralgia: definitive microsurgical treatment and results in 117 patients. Neurochirurgia 20:145, 1977.

[11] 11. JANNETTA, P. J. & ZORUB, D. S. - Microvascular Decompression for Trigeminal Neuralgia. Raven Press, New York, 1979, pág. 143.

[12] 12. JANNETTA, P. J. - Neurovascular compression in cranial nerve and systemic disease. Ann. Surg. 192:518, 1980.

[13] 13. KLAUS, E. - Die basilaere Impression. S. Hirzel, Leipzig, 1969.

[14] 14. MUELLER, H. R. & LEVY, A. - Zur Pathogenese der Trigeminusneuralgie. Acta Neurochir. 11:385, 1963.

[15] 15. OBRADOR, S. & BOIXADÔS, J. R. - Neuralgia del trigemino secundaria a impresion basilar y platibasia. Rev. clin. esp. 58:233, 1955.

[16] 16. OBRADOR, S.; QUEIMADELOS, V. G. & SOTO, M. - Trigeminal neuralgia secondary to asymmetry of the petrous bone: case report. J. Neurosurg. 33:596, 1970.

[17] 17. OLIVECRONA, H. - Die Trigeminusneuralgie und ihre Behandlung. Nervenarzt 14:49, 1941.

[18] 18. SATO, O.; KAN AZAWA, I. & KOKUNAI, T. - Trigeminal neuralgia caused by compression of trigeminal nerve by pontine vein. Surg. Neurol. 11:285, 1979.

[19] 19. SCHUELLER, A. - Zur Roentgen-Diagnose der basalen Impression des Schaedels. Wien. med. Wschr. 40:2594, 1911.

[20] 20. SPRUNG, H. B. - Beitrag zur Genese der idiopathischen Trigeminusneuralgie. Zbl. Neurochir. 13:284, 1953.

[21] 21. TAYLOR, A. R. & CHAKRAVORTY, B. C. - Clinical syndromes associated with basilar impression. Archs Neurol. (Chicago) 10:475, 1964.

[22] 22. WAGA, S.; MORIKAWA, A. & KOJIMA, T. - Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg. Neurol. 11:13, 1979.

[23] 23. WEBER, E. - Die Form der Schaedelbasis in ihrer Beziehung zum Gesichtsschmerz, speziell zur Trigeminusneuralgie. Acta Neurochir. Suppl. 3:72, 1955.

[24] 24. WEBER, E. - Zur Problematik der Trigeminus-Neuralgie. Nervenarzt 31:88, 1960.