Anatomical Study of Percutaneous Trigeminal Compressive Balloon Positioning on Merged 3-D Rotational X-Ray and Preprocedural Magnetic Resonance Imaging.

Background: Percutaneous trigeminal rhizotomy or balloon compression for trigeminal neuralgia carries a potential risk for the brainstem, the carotid artery, and the basilar artery.

Objective: To detail the relation of critical neural and vascular structures to expanded balloons used for percutaneous compression of the trigeminal ganglion.

Method: A retrospective analysis of preprocedural magnetic resonance imaging (MRI) and procedural X-ray-based imaging for 9 patients detailed balloon proximity to the brainstem, carotid artery, and basilar artery.

Pseudomeningocele Aspiration and Blood Patch Effectively Treats Positional Headache Associated With Postoperative Lumbosacral Pseudomeningocele.

Study Design: Retrospective chart review with limited prospective follow-up survey.

Objective: To evaluate the efficacy and safety of blood patch injection for the treatment of positional headaches caused by postoperative lumbosacral pseudomeningoceles.

Summary Of Background Data: Pseudomeningocele is one of the most common complications after posterior lumbosacral spinal surgery.

Nucleus caudalis dorsal root entry zone lesioning for the treatment of anesthesia dolorosa.

Deafferentation facial pain (anesthesia dolorosa) can occur after injury of the first-order trigeminal nerve. It is often debilitating and difficult to treat. The authors report the treatment of anesthesia dolorosa in a 69-year-old man with a 7-year history of pain.

Nucleus caudalis lesioning: Case report of chronic traumatic headache relief.

Background: The nucleus caudalis dorsal root entry zone (DREZ) surgery is used to treat intractable central craniofacial pain. This is the first journal publication of DREZ lesioning used for the long-term relief of an intractable chronic traumatic headache.

Case Description: A 40-year-old female experienced new-onset bi-temporal headaches following a traumatic head injury.

Trigeminal nucleus caudalis anatomy: guidance for radiofrequency dorsal root entry zone lesioning.

Object: This study seeks to improve the accuracy of trigeminal nucleus caudalis dorsal root entry zone (DREZ) radiofrequency lesioning by quantifying the size and orientation of the nucleus caudalis.

Methods: Using serial axial photographs of 6 formalin-fixed cadaver brainstems, digital nucleus caudalis measurements were taken at 1-mm intervals from the level of the obex to the C(2) dorsal nerve roots.

Results: From the obex to the C(2) dorsal nerve roots, the nucleus caudalis decreases in width (from 2.

An efficient hand-tying technique for vessel ligation.

Vessel ligation is a fundamental surgical skill that must be performed efficiently. By identifying and eliminating redundant hand movements, we developed a more smooth method for tying a first knot around a hemostat-clamped vessel. The knot is made while the suture is being passed around the hemostat.