Romanian Neurosurgery (Sep 2018)
Computational fluid dynamics as an indicator of offending vessel in trigeminal neuralgia and hemifacial spasms
Abstract
Context: Newer Imaging tool for diagnosing offending vessel in trigeminal neuralgia (TN) and Hemifacial spasms (HFS). Aim: To find out if Computational FluidDynamics (CFD) can correctly predict the offending vessel in HFS and TN & thus improving the outcome of Microvascular Decompression) MVD. Settings and Design: CFD is a relatively new mode of imaging. Its application to indicate offending vessel in TN & HFS was tested. Materials & Methods: Retrospectively we studied 13 consecutive patients operated in 2017 for either HFS or TN. Preoperatively MRI & Computed Tomography Angiogram (CTA) were done and the offending vessel identified along with its point of contact with the concerned nerve. CFD was done using Hemoscope 2015 software and wall pressure, wall shear stress, vector & streamline flow were obtained in the offending vessel (test) & contralateral vessel (control). Results of these were charted on an excel sheet & results analyzed. The postoperativeoutcome were assessed and compared with CFD results. Statistical analysis used: Small study group hence statistical analysis couldn’t be applied. Results: Of the 13 patients, offending artery had high wall pressure in 12 and increased wall shear stress innine. Among the controls six had high wall pressure and only two had high wall shear stress. Conclusion: CFD can be used to determine offending vessel and can predict good outcome following microvascular decompression.
