三叉小脳動脈の圧迫による三叉神経痛に対する脳神経減圧術

Microvascular Decompression for Trigeminal Neuralgia Caused by Trigeminocerebellar Artery

Point

・三叉神経痛の責任血管として，三叉小脳動脈（TCA）が存在する．

・TCAは脳底動脈より分枝し，三叉神経根周囲で蛇行し巻き付くように走行する．

・TCAによる三叉神経痛に対する脳神経減圧術は，その解剖学的特徴より難易度の高いものとなる．

＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2027年2月まで）。

　The trigeminocerebellar artery（TCA）is a unique branch of the basilar artery. The TCA was first described in detail by Markovic et al. in 1996. The incidence of TCA was 6.9%-13.3% in previous cadaveric studies.

　The TCA branches from the distal part of the basilar artery, courses very close to the trigeminal nerve root entry zone, and occasionally twists or encircles the nerve root. A close relationship between the TCA and trigeminal nerve can cause trigeminal neuralgia（TN）. This characteristic course of TCA requires adjuvant decompression techniques performed by the operators. In the microvascular decompression for TN caused by the TCA, operators should pay attention to the following: 1）sufficient arachnoid dissection around the TCA, 2）combined transposition and interposition technique, 3）decompression of perforators and vessels penetrating the nerve, and 4）recognition of the existence of the TCA.