Tumors of the gasserian ganglion; tumor of the left gasserian ganglion associated with enlargement of the mandibular nerve; a review of the literature and case report.
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Humans↗
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Thermogangliolysis of the Gasserian ganglion under computed tomography fluoroscopy.
Gasserian ganglion block is an established treatment for trigeminal neuralgia. A landmark approach assisted by X-ray fluoroscopy is the most common method; however, visualization of the foramen ovale is difficult in some cases. Here we report two cases in which a novel technique using modern computed tomography (CT) fluoroscopy was employed. A 63-year-old woman suffering pain in the maxillary nerve area was treated by thermogangliolysis under CT fluoroscopy. The patient was positioned on a CT stage with the head in an overhanging position. The CT gantry was set at an oblique angle to obtain a coronal view of the foramen ovale. The safest and shortest route to the foramen was designed using the CT image and a 22-gauge insulated needle was advanced following the designed route under CT fluoroscopy. The effect of the nerve block was estimated by injection of a test dose of mepivacaine, after which the ganglion was thermally coagulated at 90 degrees C. Satisfactory analgesia was obtained in this case without any complications. Another patient (65 years old) was also treated by the same technique, and satisfactory pain relief was obtained. In conclusion, CT fluoroscopy-guided Gasserian ganglion thermolysis is considered a safe, quick, and effective treatment for trigeminal neuralgia.
Aged↗
Depletion of calcitonin gene-related peptide from the caudal trigeminal nucleus of the rat after electrical stimulation of the Gasserian ganglion.
Electrical stimulation of the Gasserian ganglion resulted in partial depletion of calcitonin gene-related peptide (CGRP) from ipsilateral central terminals of pseudounipolar primary sensory ganglion cells. Affected terminals exhibit decreased CGRP immunoreactivity as shown by cytophotometric densitometry of the caudal trigeminal nucleus. The decrease in CGRP immunoreactivity is statistically significant only in the medial one-third of the caudal trigeminal nucleus. Since earlier studies have shown that electrical stimulation of the Gasserian ganglion induces first accumulation then depletion of CGRP from perivascular sensory terminals in the dura mater, the present experiments suggest that CGRP is depleted also from central terminals of primary sensory trigeminal neurons, which might be of importance in the pathogenesis of migraine headache.
Animals↗
Eosinophilic leukemia infiltrating the gasserian ganglion.
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Humans↗
[Histophotometric study of the early post-irradiation changes in the desoxyribonucleic acid (DNA) in the ganglionic cells of the gasserian ganglion of rats irradiated with Co-60].
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Animals↗
[Histophotmetric study of the early post-irradiation changes in cytoplasmatic ribonucleic acid (RNA) in the ganglionic cells of the gasserian ganglion of rats irradiated with Co-60].
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Animals↗
[Contribution to the knowledge of the relationship between trauma and herpes zoster (case following the alcoholization of the gasserian ganglion)].
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Herpes Zoster↗
Inhibition by transcutaneous electrical stimulation of noxious heat elicited in human Gasserian ganglion.
During percutaneous thermocoagulation of the Gasserian ganglion for trigeminal pain, the pain perception threshold was established in a series of 25 awake patients by measuring the temperature at the electrode tip within the ganglion during slow increase of the radiofrequency current. Between 42 and 48 degress C pain perception was regularly reported by the patients. A cutaneous-stimulating system was then applied to the trigeminal area which was reported to be painful during the heating. The external stimulation attempted to preferentially stimulate the A afferent nerve fibres. When external stimulation was applied during the heating of the Gasserian ganglion, the pain perception threshold was enhanced in about half of the cases. A transcutaneous electrical stimulation of part of the body not related with the investigated pain sensation did not produce the same inhibitory action in 3 out of 5 cases.
Adult↗
Trigeminal evoked potentials in patients undergoing percutaneous microcompression of gasserian ganglion.
22 patients undergoing percutaneous microcompression of Gasserian ganglion for the treatment of trigeminal neuralgia were monitored intraoperatively by means of trigeminal evoked potentials (TEPs). The second trigeminal branch was stimulated at the maxillary foramen; evoked responses were recorded using subcutaneous electrodes placed over the scalp. TEPs presented several short-latency waves (called W1, W2, W3, P4, N5, P6, N10) which are generated before and after the ganglion (W1, W2, W3), in the brain stem (P4, N5, P6) and possibly in the cortex (N10); other waves occur within 150 ms after the stimulus (late waves). During compression, W1 did not change, while W2 and W3 as well as P4, N5, P6, N10 and late waves decreased in amplitude: this pattern was noted in the patients who presented with pain relief during the follow-up period. On the contrary, the patients who suffered from pain recurrence did not show similar intraoperative TEP changes. In conclusion, intraoperative TEP derangements may be related to the effectiveness of the compression on the Gasserian ganglion.
Aged↗
Anaesthetic considerations in percutaneous radiofrequency coagulation of the Gasserian ganglion.
This study determined the cardiovascular effects of percutaneous radiofrequency coagulation of the Gasserian ganglion, performed under neuroleptanalgesia and intermittent ultrashort-acting barbiturate anaesthesia. Twelve ASA physical status class II patients were studied. Highly significant increases in mean heart rate and arterial blood pressure followed the insertion of the cannula electrode into the Gasserian ganglion (p less than 0.001). In six randomly assigned patients severe tachycardia and hypertension also accompanied the progress of the thermal lesion (p less than 0.0001). Three patients developed premature ventricular contractions, and two developed significant ST segment depression. Intravenous nitroglycerin, used during current generation, successfully controlled the hypertensive response in the other six patients. In percutaneous thermocoagulation of the Gasserian ganglion the patient's co-operation is essential. In addition to providing suitable operating conditions for both surgeons and patient, we should also be able to maintain normal and stable cardiovascular haemodynamics. Intravenous nitroglycerin used as an adjunct to light general anaesthesia safely maintained intraoperative normotension. It is also suggested that patients with coronary artery disease be adequately monitored and protected during the procedure.
Aged↗
Primary malignant nerve sheath tumor of the gasserian ganglion: a report of two cases.
Primary tumors of the gasserian ganglion are usually benign, and secondary tumors are malignant. We report two cases of a malignant primary tumor of the gasserian ganglion, bringing the total in the world literature to five. The presentation, etiological features, and treatment of these cases are reviewed, together with a review of the literature. Preoperative differentiation from a benign tumor is not possible with certainty. A combination of operation and radiation therapy seems to be the best treatment at present.
Aged↗
Amyloidoma of the gasserian ganglion.
We report an unusual case of an amyloidoma of the gasserian ganglion associated with trigeminal neuralgia. MR imaging showed a mass in Meckel's cave, which was isointense with surrounding tissue on T1-weighted images and hypointense on T2-weighted images. After contrast administration, the mass enhanced homogeneously, and thin cuts through the region showed involvement in the expected location of the gasserian ganglion and, more laterally and inferiorly, in the proximal part of V1. A review of the literature revealed that only one similar case has been reported since the advent of modern neuroimaging. Amyloidoma, although rare, may be considered as a rare differential diagnosis of a mass in this region.
Amyloid Neuropathies↗
Amyloidoma in the gasserian ganglion: case report.
BACKGROUND: Amyloidoma in the central nervous system is extremely rare. We describe a rare case of amyloidoma in the gasserian ganglion manifesting as trigeminal neuropathy. METHODS: A 41-year-old woman was admitted to our hospital with progressive numbness and hypalgesia in the distribution of the second and third divisions of the left trigeminal nerve. There was no evidence of chronic inflammatory disorder or immunological abnormalities. Magnetic resonance images showed a mass in the left Meckel's cave that was brightly enhanced with gadolinium. RESULTS: A reddish, firm mass was successfully removed via a left temporal craniotomy. Histologically, the tumor was composed of larger acellular deposits of eosinophilic material. The acellular deposits were positive for potassium permanganate-resistant Congo red staining, showing apple-green birefringence under polarized light and expression of immunoglobulin lambda light chain-derived proteins (A lambda) immunohistochemically. CONCLUSION: The present case revealed an A lambda amyloidoma in the left gasserian ganglion. Although the incidence is rare, amyloidoma should be suspected in patients who complain of progressive trigeminal neuropathies and show an enhanced lesion in the gasserian ganglion on MR images.
Adult↗
[Neurinomas of the Gasserian ganglion and the trigeminal nerve (author's transl)].
Two cases of Gasserian ganglion neurinomas in children are described. The onset in both cases was insidious and the tumors became very large before the first clinical signs appeared. Blindness of one eye by direct compression of the homolateral optic nerve was the main symptom in both instances. In one child homolateral exophthalmus was also present. The clinical course of both cases was completely painless and without any other sign of involvement of the trigeminal nerve. Abnormal vessels related to the tumor were visible in the arterial phase of carotid angiography. This angiographic finding (unique in appearance and distribution) may be considered as pathognomonic for tumors of the Gasserian ganglion.
Adolescent↗
The trigeminal system in the pigeon (Columba livia). I. Projections of the gasserian ganglion.
The central projections of the Gasserian ganglion were investigated in the pigeon, Columba livia. Lesions were placed in the ganglion either by direct surgical exposure or stereotaxically, and following survival times of one to four days, the brains stained with the Fink-Heimer method. The main group of central axons bifurcate to form distinct ascending and descending branches, the tractus trigemini ascendens (TTA) and the tractus trigemini descendens (TTD). A smaller tract also courses caudally (ITTD) separate of TTD proper to terminate in the nucleus cuneatus externus. The TTA projects topographically upon the principal sensory nucleus of the trigeminus, ending in both the pars dorsalis and a smaller pars ventralis. The neurons at the point of bifurcation of the entering radix have been designated as the pars oralis of nTTD. The TTD distributes caudally to several distinct subnuclei at each level, and extends into the cervical spinal cord. Relatively discrete regions corresponding to the pars interpolaris and caudalis were recognized. The projections to the cervical cord terminate in laminae I-IV. There was no evidence of projections to the cerebellum, or contralateral PrV or TTD. There was a small projection to the contralateral cervical spinal cord. No clear evidence of a projection to the nucleus solitarius was found. The distribution of primary trigeminal axons is compared to that described in other vertebrates.
Animals↗
Pressure monitoring inside Meckel's cave during percutaneous microcompression of gasserian ganglion.
During percutaneous microcompression of the gasserian ganglion for the relief of trigeminal neuralgia, a computerized technique for monitoring the pressure inside Meckel's cave was employed in 22 patients. A dedicated transducer connected to a computer records the balloon inflation pressure. Its variations are discernible within tenths of a bar and are plotted in relation to time. The intraoperative pressure inside Meckel's cave is from 0.9 to 2.4 bars. When pressure was low, there was recurrence of pain. The highest values of pressure (1.9-2.4 bars) were observed in most of the patients suffering from untoward side effects. The clinical results seem to be influenced by the level of the intraoperative intracavitary pressure.
Aged↗
Gasserian ganglion: appearance on contrast-enhanced MR.
PURPOSE: To characterize the appearance of the gasserian ganglion on contrast-enhanced MR images. METHODS: We retrospectively reviewed the MR images from 57 patients with suspected pituitary disease. These patients had undergone unenhanced and contrast-enhanced MR imaging of the sella, including evaluation of Meckel's cave. None of the patients had clinical signs or symptoms referable to the fifth cranial nerve or ganglion. Correlation was made with a previous study that compared gross anatomy with high-resolution CT scans of cadaveric specimens. RESULTS: A discrete semilunar enhancing structure within the inferolateral aspect of Meckel's cave was identified in 100 of the 114 caves examined; the other 14 caves had a thickened area of enhancement that blended with the dura inferolaterally. A small semilunar structure within the inferolateral aspect of Meckel's cave was also identified on CT scans of the cadaveric specimens. CONCLUSION: The gasserian ganglion enhances on MR images and should not be confused with a pathologic process.
Cavernous Sinus↗
[Parameters of high-frequency thermocoagulation of the Gasserian ganglion in the treatment of trigeminal neuralgia in order to obtain analgesia without anesthesia].
Voltage and current within Gasserian ganglion have been measured during a therapeutical high frequency coagulation of the Gasserian ganglion in 25 consecutive cases. From these values, the impedance (Ohm), the work (Watt) and the total energy (Joule) necessary to obtain an analgesia without anesthesia have been calculated. The study has shown that the temperature and the time of coagulation in correlation with the length of the non isolated tip of the electrode are actually the only constancy in the control of the therapeutical lesions.
Electrocoagulation↗