Central Asian Journal of Medicine


Background. In this study authors analyzed hemodynamic features of offending vessels with CFD study in hemifacial spasm and trigeminal neuralgia and compared with 3D Fusion images and real time surgery findings. Materials and methods. 9 cases of NVCs in trigeminal neuralgia and hemifacial spasm were studied at Fujita Health University Banbuntane Hotokukai Hospital during fellowship training from August to October 2019. CFD analyzes of offending vessels was carried out preoperatively and compared with real time surgery findings. All patients were evaluated by 3D MR cisternography, 3D MR angiography (MRA) and 3D CT angiography (CTA) to analyze fluid dynamic on Hemoscope 2. Rertosigmoid approach with microvascular decompression was performed using surgical microscope OPMI Pentero 900 (Carl Ziess, Germany). Results. All cases represented with high WSSm, SL, and altered WSSv but in 55% increased WP, 33,4% moderate WP, 12% decreased WP were seen at NVC site. At both NVCp and NVCd, there were low WSSm, SL and normal WSSv in all Cases, However, in 5 cases we identified more than one NVc representing with either increased or moderate WP that were more increased at NVCp than NVCd. In one case preoperative MRI confirmed meningiomas of Meckel’s cave. During endoscopic removal of meningioma, CSA compressing V nerve was observed and MVD with transposition was performed. After surgery, we analyzed preoperative CTA of SCA via CFD and identified that there was NVCs with increased WP, High WSSm, SL and altered WSSv which corresponded to findings of real time surgery. Conclusion. Offending vessels in NVCs represents with high WSSm, SL, increased WP and altered WSSv at contact site that are useful to identify exact location of compression parts of offending vessels before surgery.

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