{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:48:39Z","timestamp":1792176519811,"version":"4.4.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Trigeminal neuralgia (TN) occurs and recurs in the absence of neurovascular compression (NVC). To characterize what may be distinct patient populations, the authors examined age at onset in patients with TN with and without NVC.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A retrospective review of patients undergoing posterior fossa surgery for Type I TN at Oregon Health &amp; Science University from 2009 to 2013 was undertaken. Charts were reviewed, and imaging and operative data were collected for patients with and without NVC. Mean, median, and the empirical cumulative distribution of onset age were determined. Statistical analysis was performed using Student t-test, Wilcoxon and Kolmogorov-Smirnoff tests, and Kaplan-Meier analysis. Multivariate analysis was performed using a Cox proportional hazards model.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The charts of 219 patients with TN were reviewed. There were 156 patients who underwent posterior fossa exploration and microvascular decompression or internal neurolysis: 129 patients with NVC and 27 without NVC. Mean age at symptoms onset for patients with and without NVC was 51.1 and 42.6 years, respectively. This difference (8.4 years) was significant (t-test: p = 0.007), with sufficient power to detect an effect size of 8.2 years. Median age between groups with and without NVC was 53.25 and 41.2 years, respectively (p = 0.003). Histogram analysis revealed a bimodal age at onset in patients without NVC, and cumulative distribution of age at onset revealed an earlier presentation of symptoms (p = 0.003) in patients without NVC. Chi-square analysis revealed a trend toward female predominance in patients without NVC, which was not significant (p = 0.08). Multivariate analysis revealed that age at onset was related to NVC but not sex, symptom side or distribution, or patient response to medical treatment.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>NVC is neither sufficient nor necessary for the development of TN. Patients with TN without NVC may represent a distinct population of younger, predominantly female patients. Further research into the pathophysiology underlying this debilitating disease is needed.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.11.jns141741","type":"journal-article","created":{"date-parts":[[2015,6,5]],"date-time":"2015-06-05T14:06:53Z","timestamp":1433513213000},"page":"1519-1527","source":"Crossref","is-referenced-by-count":66,"title":["Trigeminal neuralgia without neurovascular compression presents earlier than trigeminal neuralgia with neurovascular compression"],"prefix":"10.3171","volume":"123","author":[{"given":"Andrew L.","family":"Ko","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Indiana, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Raslan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alp","family":"Ozpinar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"McCartney","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim J.","family":"Burchiel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns141741","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1056\/NEJM199604253341701","article-title":"The long-term outcome of microvascular decompression for trigeminal neuralgia","volume":"334","author":"Barker","year":"1996"},{"key":"b2-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"138","DOI":"10.3171\/jns.1967.26.1part2.0138","article-title":"Electron microscopy of the Gasserian ganglion in trigeminal neuralgia","volume":"26","author":"Beaver","year":"1967"},{"key":"b3-jns141741","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1227\/01.NEU.0000088806.11659.D8","article-title":"A new classification for facial pain","volume":"53","author":"Burchiel","year":"2003"},{"key":"b4-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3171\/jns.1988.69.1.0035","article-title":"Long-term efficacy of microvascular decompression in trigeminal neuralgia","volume":"69","author":"Burchiel","year":"1988"},{"key":"b5-jns141741","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1227\/00006123-198108000-00001","article-title":"Comparison of percutaneous radiofrequency gangliolysis and microvascular decompression for the surgical management of tic douloureux","volume":"9","author":"Burchiel","year":"1981"},{"key":"b6-jns141741","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/S0002-9610(34)90403-7","article-title":"Concerning the cause of trigeminal neuralgia","volume":"24","author":"Dandy","year":"1934"},{"key":"b7-jns141741","series-title":"Pain","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.pain.2013.08.029","article-title":"Abnormal trigeminal nerve microstructure and brain white matter in idiopathic trigeminal neuralgia","volume":"155","author":"DeSouza","year":"2014"},{"key":"b8-jns141741","series-title":"Clin J Pain","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1097\/00002508-200201000-00002","article-title":"Pathophysiology of trigeminal neuralgia: the ignition hypothesis","volume":"18","author":"Devor","year":"2002"},{"key":"b9-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"532","DOI":"10.3171\/jns.2002.96.3.0532","article-title":"Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery","volume":"96","author":"Devor","year":"2002"},{"key":"b10-jns141741","series-title":"Pain","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.1016\/j.pain.2013.04.010","article-title":"Diffusion tensor imaging detects microstructural reorganization in the brain associated with chronic irritable bowel syndrome","volume":"154","author":"Ellingson","year":"2013"},{"key":"b11-jns141741","series-title":"Cereb Cortex","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1093\/cercor\/bhp205","article-title":"Brain anatomy changes associated with persistent neuropathic pain following spinal cord injury","volume":"20","author":"Gustin","year":"2010"},{"key":"b12-jns141741","series-title":"Cephalalgia","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1177\/0333102413485658","article-title":"The International Classification of Headache Disorders, 3rd edition (beta version)","volume":"33","author":"Headache Classification Committee of the International Headache Society (IHS)","year":"2013"},{"key":"b13-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"159","DOI":"10.3171\/jns.1967.26.1part2.0159","article-title":"Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia","volume":"26","author":"Jannetta","year":"1967"},{"key":"b14-jns141741","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1097\/00006123-200103000-00013","article-title":"Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients","volume":"48","author":"Kanpolat","year":"2001"},{"key":"b15-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"132","DOI":"10.3171\/jns.1967.26.1part2.0132","article-title":"Correlated light and electron microscopic observations on the normal trigeminal ganglion and sensory root in man","volume":"26","author":"Kerr","year":"1967"},{"key":"b16-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"151","DOI":"10.3171\/jns.1967.26.1part2.0151","article-title":"Pathology of trigeminal neuralgia: light and electron microscopic observations","volume":"26","author":"Kerr","year":"1967"},{"key":"b17-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3171\/jns.1967.26.1part2.0175","article-title":"Evidence for a central etiology of tic douloureux","volume":"26","author":"King","year":"1967"},{"key":"b18-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","DOI":"10.3171\/201412.JNS14469","article-title":"Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without vascular compression","author":"Ko"},{"key":"b19-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1016\/j.ejrad.2012.11.027","article-title":"Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression. Clinical article","volume":"120","author":"Lee","year":"2014"},{"key":"b20-jns141741","series-title":"Eur J Radiol","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1002\/art.24070","article-title":"Microstructural abnormalities in the trigeminal nerves of patients with trigeminal neuralgia revealed by multiple diffusion metrics","volume":"82","author":"Liu","year":"2013"},{"key":"b21-jns141741","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"3960","DOI":"10.1097\/AJP.0b013e31817e138e","article-title":"White and gray matter abnormalities in the brain of patients with fibromyalgia: a diffusion-tensor and volumetric imaging study","volume":"58","author":"Lutz","year":"2008"},{"key":"b22-jns141741","series-title":"Clin J Pain","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1159\/000353188","article-title":"\u201cNerve combing\u201d for trigeminal neuralgia without vascular compression: report of 10 cases\u201d","volume":"25","author":"Ma","year":"2009"},{"key":"b23-jns141741","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3171\/2008.6.17604","article-title":"Use of an artificial neural network for diagnosis of facial pain syndromes: an update","volume":"92","author":"McCartney","year":"2014"},{"key":"b24-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.3171\/2008.6.17620","article-title":"Classification of trigeminal neuralgia: clinical, therapeutic, and prognostic implications in a series of 144 patients undergoing microvascular decompression","volume":"111","author":"Miller","year":"2009"},{"key":"b25-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3171\/2008.9.17660","article-title":"Radiographic evaluation of trigeminal neurovascular compression in patients with and without trigeminal neuralgia","volume":"110","author":"Miller","year":"2009"},{"key":"b26-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/j.wneu.2010.01.027","article-title":"Predictors of long-term success after microvascular decompression for trigeminal neuralgia","volume":"110","author":"Miller","year":"2009"},{"key":"b27-jns141741","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.surneu.2005.10.018","article-title":"Surgical management of trigeminal neuralgia patients with recurrent or persistent pain despite three or more prior operations","volume":"73","author":"Pollock","year":"2010"},{"key":"b28-jns141741","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.wneu.2012.07.030","article-title":"Surgical treatment of trigeminal neuralgia without vascular compression: 20 years of experience","volume":"66","author":"Revuelta-Guti\u00e9rrez","year":"2006"},{"key":"b29-jns141741","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.jpain.2004.11.004","article-title":"Efficacy and safety of root compression of trigeminal nerve for trigeminal neuralgia without evidence of vascular compression","volume":"80","author":"Revuelta-Gutierrez","year":"2013"},{"key":"b30-jns141741","series-title":"J Pain","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1523\/JNEUROSCI.4592-11.2012","article-title":"Functional magnetic resonance imaging and diffusion tensor imaging in a case of central poststroke pain","volume":"6","author":"Seghier","year":"2005"},{"key":"b31-jns141741","series-title":"J Neurosci","doi-asserted-by":"publisher","first-page":"3211","DOI":"10.3171\/JNS-07\/12\/1144","article-title":"Functional expansion of sensorimotor representation and structural reorganization of callosal connections in lower limb amputees","volume":"32","author":"Sim\u00f5es","year":"2012"},{"key":"b32-jns141741","series-title":"J Neurosurg","first-page":"1144","article-title":"Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression","volume":"107","author":"Sindou","year":"2007"},{"issue":"Suppl","key":"b33-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"60","DOI":"10.3171\/2013.1.JNS12875","article-title":"Gamma Knife surgery for trigeminal neuralgia: a review of 450 consecutive cases","volume":"113","author":"Verheul","year":"2010"},{"key":"b34-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.3171\/jns.1993.79.5.0680","article-title":"Long-term outcome of high-dose Gamma Knife surgery in treatment of trigeminal neuralgia. Clinical article","volume":"119","author":"Young","year":"2013"},{"key":"b35-jns141741","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1227\/01.NEU.0000159883.35957.E0","article-title":"Partial sensory trigeminal rhizotomy at the pons for trigeminal neuralgia","volume":"79","author":"Young","year":"1993"},{"key":"b36-jns141741","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1056\/NEJM199604253341701","article-title":"Patient reports of satisfaction after microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia","volume":"56","author":"Zakrzewska","year":"2005"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/123\/6\/article-p1519.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/123\/6\/article-p1519.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/123\/6\/article-p1519.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T21:53:10Z","timestamp":1658699590000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/123\/6\/article-p1519.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":36,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2014.11.jns141741","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}