{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:03:03Z","timestamp":1787025783609,"version":"build-2736575974"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,18]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Hyperactive cranial neuropathies refractory to medical management can often be debilitating to patients. While microvascular decompression (MVD) surgery can provide relief to such patients when an aberrant vessel is compressing the root entry zone (REZ) of the nerve, the arteries of elderly patients over 65 years of age can be less amenable to manipulation because of calcifications and other morphological changes. A dolichoectatic vertebral artery (DVA), in fact, can lead to multiple cranial neuropathies; therefore, a strategy for MVDs in elderly patients is useful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 76-year-old man presented with medically refractory trigeminal neuralgia (TN) and hemifacial spasm (HFS). A DVA was the conflicting vessel at the left REZs of the trigeminal and facial nerves. The authors performed a retrosigmoid craniotomy for MVD of the DVA with Teflon padding at both REZs in approximately 1 hour of operative time. The patient was free of facial pain and spasm immediately after surgery and at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The authors described the case of an elderly patient with both TN and HFS caused by compression of a DVA. Simultaneous MVD with Teflon padding at both REZs provided symptomatic relief with limited surgical time. This can be a particularly useful and straightforward surgical strategy in the elderly population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case22176","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T03:59:11Z","timestamp":1659326351000},"source":"Crossref","is-referenced-by-count":4,"title":["Simultaneous microvascular decompression for trigeminal neuralgia and hemifacial spasm involving a dolichoectatic vertebral artery in an elderly patient: illustrative case"],"prefix":"10.3171","volume":"4","author":[{"given":"Neelan J.","family":"Marianayagam","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanya M.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar","family":"Vasandani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaurey","family":"Vetsa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Jalal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Moliterno","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; and"},{"name":"Yale Brain Tumor Center, Smilow Cancer Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"17","key":"b1","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 FG 2nd","year":"1996","unstructured":"Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. 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