Microdescompresión vascular en la neuralgia esencial del trigémino

Tania Margarita Cruz Hernández, Orestes López Piloto, Carlos Pérez Rodríguez, Pedro Domínguez Jiménez, Julio César Selva Infante

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Resumen

OBJETIVO: Determinar los resultados de la microdescompresión vascular (MDV) en los pacientes con diagnóstico de neuralgia esencial del trigémino no controlados con el tratamiento médico.

MÉTODOS: Se realizó un estudio retrospectivo de una serie con neuralgia esencial del trigémino operados por MDV en los Hospitales Clínico Quirúrgicos “Lucía Iñiguez Landín” y “Hermanos Ameijeiras” en el período comprendido de enero del 2001 a marzo del 2016. Se analizaron las variables edad, sexo, ramas neurales afectadas, tipo de compresión vascular más frecuentemente encontrada, complicaciones y recidivas.

RESULTADOS: La muestra quedó conformada por 61 pacientes. El sexo femenino fue el más afectado. Mayormente los casos tenían entre 50 y 60 años de edad. Las ramas más afectadas fueron la tercera y la asociación de la segunda y tercera rama para un 43,1 % (22) y 21,5 % (11) respectivamente. La sepsis de la herida y la fístula de LCR fueron las principales complicaciones con 13,7 % (7) y 9,8 % (5). En el transoperatorio se encontró la compresión vascular en el 60,3 % (31), siempre relacionado con arteria cerebelosa superior. El 88 % (45) de los pacientes operados no presentaron recidiva.

CONCLUSIONES: La MDV es efectiva, tanto, para aliviar el dolor, como para preservar las estructuras y funciones neurales, con una mínima aparición de recidivas.

Palabras clave

Descompresión Microvascular; Enfoque retrosigmoideo; Neuralgia del trigémino; Pronóstico

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