In 1977, it became apparent that most of the cases of "idiopathic" glossopharyngeal neuralgia could be caused by vascular compression of the glossopharyngeal nerve at the nerve root entry zone
, causing a hyperactive rhizopathy.
Results: The brainstem region with increased volume located in the left ventrolateral periaqueductal gray (MNI coordinate: -1, -33, -8), ventral tegmental area (MNI coordinate: 0, -22, -12), bilateral substantia nigra (MNI coordinate: -8, -16, -12, 9, -16, -12), and trigeminal root entry zone
(MNI coordinate: -19, -29, -31; 19, -32, -29) in MOH patients compared with NCs.
Her brain magnetic resonance imaging (MRI) without contrast revealed a vascular compression of the left hemi-medulla and left 7-8 nerve complex, close to the root entry zone
, by a mildly tortuous medially-deviated left vertebral artery with normal calibre (Figures 1, 2).
Most cases are mainly recognized as glossopharyngeal nerve compression triggered by a vessel at the root entry zone
of the brainstem [148,149].
At the level of the trigeminal "root entry zone
," the myelin is of the "central type" produced by oligodendrocytes, probably less resistant to mechanical stimuli than peripheral myelin produced by Schwann cells .
Central neural injury involves injury to any part of the central nervous system from the dorsal root entry zone
(DREZ) second-order neurons up to the sensory cortex, i.e.
First recognized as a surgical entity by Dandy in 19343 through microvascular decompression (MVD) of the dorsal root entry zone
Angled endoscopes are also utilized to facilitate identification of vascular contacts at the root entry zone
and to visualize the trigeminal nerve medial to a low and prominent petrous ridge.
This edition incorporates 20 new chapters on radiofrequency lesionings, decompression and compression techniques, nerve blocks, percutaneous disketomies, percutaneous kyphoplasty, sacral nerve stimulation, cervical cordotomy, and dorsal root entry zone
Sometimes, a surgical procedure such as dorsal root entry zone
(DREZ), rhizotomy, or cordotomy is recommended, in which incisions are made in select nerve locations to interrupt the pain in the nervous system itself.
Patients received a median radiation dose of 75 gray delivered to the trigeminal nerve root entry zone
. Overall, 70% of patients reported good or excellent pain relief as defined by Barrow Neurologic Institute Pain Scale classes I-III.
Classical radiosurgery treatment for trigeminal neuralgia focuses a 4-cm beam of gamma radiation at the root entry zone
of the trigeminal nerve, said Robert M.