{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:46:47Z","timestamp":1786124807954,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2017,11,18]],"date-time":"2017-11-18T00:00:00Z","timestamp":1510963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND IMPORTANCE<\/jats:title>\n                    <jats:p>The lateral suboccipital approach for microvascular decompression (MVD) of the trigeminal nerve has become a standard-of-care over the past several decades. Syndromic cranial base settling, a rare but known cause for trigeminal neuralgia (TN), poses significant dilemmas in clinical management. In such cases, distorted anatomy may render surgery via the suboccipital approach difficult or even impossible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL PRESENTATION<\/jats:title>\n                    <jats:p>A 34-yr-old male with osteogenesis imperfecta and severe basilar invagination suffered from TN that was refractory to medication and stereotactic radiosurgery. MVD of the fifth nerve root was performed via a pterional trans-sylvian approach after 3-dimensional trajectory modeling suggested the feasibility of this approach. He experienced complete resolution of TN and remains free of both pain and medications after 18 mo of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This microsurgical trajectory, previously undescribed for TN, provides good visualization of the trigeminal root entry zone, thereby offering an excellent surgical option for severe TN in the setting of abnormal posterior fossa anatomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opx216","type":"journal-article","created":{"date-parts":[[2017,11,18]],"date-time":"2017-11-18T04:01:30Z","timestamp":1510977690000},"page":"E9-E12","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Trans-sylvian Approach to Microvascular Decompression for Trigeminal Neuralgia in Syndromic Cranial Base Settling"],"prefix":"10.1227","volume":"15","author":[{"given":"Mrityunjoy","family":"Sarkar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Pillai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,8]]},"reference":[{"issue":"12","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1212\/WNL.43.12.2603","article-title":"Communicating hydrocephalus, basilar invagination, and other neurologic features in osteogenesis imperfecta","volume":"43","author":"Charnas","year":"1993","journal-title":"Neurology"},{"issue":"6","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"950","DOI":"10.3171\/jns.1997.86.6.0950","article-title":"Basilar invagination in osteogenesis imperfecta and related osteochondrodysplasias: medical and surgical management","volume":"86","author":"Sawin","year":"1997","journal-title":"J Neurosurg"},{"issue":"6","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/BF02011910","article-title":"Craniocervical abnormalities in osteogenesis imperfecta: genetic and molecular correlation","volume":"24","author":"Sillence","year":"1994","journal-title":"Pediatr Radiol"},{"issue":"6","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1136\/jnnp.31.6.596","article-title":"Basilar impression and Arnold-Chiari malformation. A study of 66 cases","volume":"31","author":"Caetano De Barros","year":"1968","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"3","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1093\/brain\/89.3.555","article-title":"Trigeminal neuralgia\u2013hemifacial spasm\u2013paget's disease: significance of this association","volume":"89","author":"Gardner","year":"1966","journal-title":"Brain"},{"issue":"10","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.clineuro.2011.06.003","article-title":"Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature","volume":"113","author":"Cohen-Gadol","year":"2011","journal-title":"Clin Neurol Neurosurg"},{"issue":"2","key":"bib7-20240909","first-page":"151","article-title":"Surgical treatment for combined hemifacial spasm and atypical trigeminal neuralgia caused by a tortuous basilar artery. Case report and review of the literature","volume":"56","author":"Gressot","year":"2012","journal-title":"J Neurosurg Sci"},{"issue":"6","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1227\/01.NEU.0000093431.43456.3B","article-title":"Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note","volume":"53","author":"Hitotsumatsu","year":"2003","journal-title":"Neurosurgery"},{"issue":"15","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1001\/jama.1959.03010150017004","article-title":"Response of trigeminal neuralgia to decompression of sensory root: discussion of cause of trigeminal neuralgia","volume":"170","author":"Gardner","year":"1959","journal-title":"J Am Med Assoc"},{"issue":"3","key":"bib10-20240909","first-page":"93","article-title":"Transtentorial retrogasserian rhizotomy in trigeminal neuralgia by microneurosurgical technique","volume":"31","author":"Jannetta","year":"1966","journal-title":"Bull Los Angeles Neurol Soc"},{"key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/neurosurgery\/24.CN_suppl_1.538","article-title":"Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations","volume":"24","author":"Jannetta","year":"1977","journal-title":"Clin Neurosurg"},{"issue":"6","key":"bib12-20240909","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.3171\/2014.10.JNS132643","article-title":"Subtemporal transtentorial approach for recurrent trigeminal neuralgia after microvascular decompression via the lateral suboccipital approach: case report","volume":"122","author":"Ogiwara","year":"2015","journal-title":"J Neurosurg"},{"issue":"5","key":"bib13-20240909","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.3171\/2014.12.JNS14469","article-title":"Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression","volume":"122","author":"Ko","year":"2015","journal-title":"J Neurosurg"},{"issue":"2","key":"bib14-20240909","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1302\/0301-620X.66B2.6707059","article-title":"Basilar impression in osteogenesis imperfecta. A report of three cases in one family","volume":"66","author":"Pozo","year":"1984","journal-title":"J Bone Joint Surg Br"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/15\/2\/E9\/30206728\/opx216.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/01787389-201808000-00020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:45:52Z","timestamp":1786121152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201808000-00020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,18]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opx216","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,18]]},"assertion":[{"value":"2017-06-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}