Online ISSN: 2515-8260

Keywords : MVD

Factors affecting the surgical outcome of microvascular decompression in trigeminal neuralgia

Dr. Vivek Kumar, Dr. Kanishk Goyal, Dr. Vinay, Dr Anita Jagetia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 465-474

Background: Microvascular decompression is an established surgical modality for treatment of trigeminal neuralgia with variable long-term success rates depending on numerous patient and disease related factors. 
Methods: A prospective study was done including 31 patients, aged between 18 to 74 years who underwent microvascular decompression for primary trigeminal neuralgia at our institution. Barrows neurological institute pain intensity scale and facial numbness score were used to assess outcome till 1 year follow up period. 
Results: 71% patients were suffering from typical trigeminal neuralgia with involvement of both V2 and V3 divisions being the most common presentation. All patients achieved favorable outcome based on BNI pain and numbness score in the immediate post-operative period however at one year 3 patients had un-favourable pain score. Younger age, longer duration of neuralgia before surgery, involvement of all three trigeminal nerve divisions, pure venous compression and presence of focal arachnoiditis were factors associated with poor outcome. 
Conclusions: MVD is a safe and effective procedure in all age groups including elderly patients with both typical and atypical symptomatology. It is seen to be effective in relieving both arterial and mixed venous neurovascular conflict especially in patients with NVC grade III severity. However, the distribution of pain in all three divisions of trigeminal nerve, pure venous compression and presence of focal arachnoiditis seem to be associated with poorer outcome. 

VEGF-A, VEGFR-2 and MVD in brain tumor tissue

Agnieszka Nowacka; Wojciech Smuczyński; Maciej Śniegocki; Kamila Woźniak- Dąbrowska

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1180-1187

Neoangiogenesis plays a crucial role in tumor development. The method that is most commonly recommended for assessing this process is determining the so-called microvessel density (MVD) in the tissue sample. In relation to tumors of the central nervous system, it seems that VEGF-A along with its receptor VEGFR-2 are the most significant factors, and the important role of both of them is connected with their increased expression in tumor tissue. The study concerned 48 adult patients of both genders, treated surgically for newly diagnosed solid brain tumors andconsisted of histological assessment of the material gained from the surgically removed brain tumor. The highest level of VEGF in tumor tissue was observed in gliomas – mostly HGG - 12.61 (N = 23, p = 0.000059). As for VEGFR-2 in tumor tissue, the highest average level was characteristic for metastatic tumors - 13.67 (N = 6, p = 0.037) and it was slightly lower in HGG - 12.2 (N = 23, p = 0.037). The average MVD in tumor tissue was the highest in HGG - 20.13 (N = 23, p = 0.047) and other tumors - 18.33 (N = 3, p = 0.047). The remaining types of tumors in the studied group had similar microvessel density – from 13.67 to 14.71.