Prognostic factors for outcome of microvascular decompression in trigeminal neuralgia: A prospective systematic study using independent assessors
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Prognostic factors for outcome of microvascular decompression in trigeminal neuralgia : A prospective systematic study using independent assessors. / Heinskou, Tone Bruvik; Rochat, Per; Maarbjerg, Stine; Wolfram, Frauke; Brennum, Jannick; Olesen, Jes; Bendtsen, Lars.
In: Cephalalgia, Vol. 39, No. 2, 2019, p. 197-208.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prognostic factors for outcome of microvascular decompression in trigeminal neuralgia
T2 - A prospective systematic study using independent assessors
AU - Heinskou, Tone Bruvik
AU - Rochat, Per
AU - Maarbjerg, Stine
AU - Wolfram, Frauke
AU - Brennum, Jannick
AU - Olesen, Jes
AU - Bendtsen, Lars
PY - 2019
Y1 - 2019
N2 - Introduction: There is a lack of high-quality prospective, systematic studies using independent assessors of outcome of microvascular decompression as treatment for trigeminal neuralgia. Methods: Clinical characteristics and outcome data were recorded prospectively from consecutive classical trigeminal neuralgia patients, using standardized interviews. Degree of neurovascular contact was evaluated by a 3.0 Tesla MRI blinded to symptomatic side. Patients were assessed before and 12 months after surgery by a neurologist. Results: Twenty-six men and 33 women completed 12 months follow-up. Forty-one patients (69%) had an excellent outcome (no pain, no medication). Ten (18%) patients had a good outcome. Eight (12%) patients had no improvement or had worsening of pain. MRI showed neurovascular contact with morphological changes in 34 patients (58%). Odds ratio between neurovascular contact with morphological changes and excellent outcome was 4.4 (Cl 1.16–16.26), p = 0.029. Odds ratio between male sex and excellent outcome was 11.38 (Cl 2.12–59.52), p = 0.004. No significant association was found between excellent outcome and concomitant persistent pain, current age or disease duration. Conclusion: Neurovascular contact with morphological changes and male sex are positive predictive factors for outcome of microvascular decompression. The findings enable clinicians to better inform patients before surgery.
AB - Introduction: There is a lack of high-quality prospective, systematic studies using independent assessors of outcome of microvascular decompression as treatment for trigeminal neuralgia. Methods: Clinical characteristics and outcome data were recorded prospectively from consecutive classical trigeminal neuralgia patients, using standardized interviews. Degree of neurovascular contact was evaluated by a 3.0 Tesla MRI blinded to symptomatic side. Patients were assessed before and 12 months after surgery by a neurologist. Results: Twenty-six men and 33 women completed 12 months follow-up. Forty-one patients (69%) had an excellent outcome (no pain, no medication). Ten (18%) patients had a good outcome. Eight (12%) patients had no improvement or had worsening of pain. MRI showed neurovascular contact with morphological changes in 34 patients (58%). Odds ratio between neurovascular contact with morphological changes and excellent outcome was 4.4 (Cl 1.16–16.26), p = 0.029. Odds ratio between male sex and excellent outcome was 11.38 (Cl 2.12–59.52), p = 0.004. No significant association was found between excellent outcome and concomitant persistent pain, current age or disease duration. Conclusion: Neurovascular contact with morphological changes and male sex are positive predictive factors for outcome of microvascular decompression. The findings enable clinicians to better inform patients before surgery.
KW - Facial pain
KW - morphological changes
KW - neurosurgery
KW - neurovascular contact
KW - predictive factors
U2 - 10.1177/0333102418783294
DO - 10.1177/0333102418783294
M3 - Journal article
C2 - 29896973
AN - SCOPUS:85049044281
VL - 39
SP - 197
EP - 208
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 2
ER -
ID: 235784412