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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se realiza un estudio anatomorradiol&#243;gico de la t&#233;cnica de microcompresi&#243;n percut&#225;nea del nervio trig&#233;mino sobre 20 ganglios de Gasser en 10 cad&#225;veres de pacientes fallecidos por causa no neurol&#243;gica&#46; Se analizan los diferentes pasos t&#233;cnicos&#44; la morfolog&#237;a radiol&#243;gica del bal&#243;n con su correlaci&#243;n anat&#243;mica y los efectos del llenado del bal&#243;n&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Las formas radiol&#243;gicas del bal&#243;n m&#225;s frecuentemente encontradas han sido la redondeada&#44; fusiforme&#44; de pera y de reloj de arena&#46; Todas ellas podemos encontrarlas en un mismo ganglio de Gasser dependiendo del volumen de contraste introducido dentro del bal&#243;n y de la localizaci&#243;n del mismo&#46; Hemos comprobado que la apariencia piriforme caracter&#237;stica&#44; es debida en todos los casos&#44; a la protrusi&#243;n de la punta del globo por el porus trig&#233;mini&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los efectos mec&#225;nicos que localmente se producen con la insuflaci&#243;n del bal&#243;n son nerviosos y durales&#58; se produce una &#171;compresi&#243;n nerviosa&#187; a nivel del ganglio de Gasser y de la ra&#237;z trigeminal&#44; as&#237; como una distensi&#243;n de la duramadre propia y por lo tanto&#44; una verdadera &#171;descompresi&#243;n dural&#187; que bien pudiera influir en los resultados cl&#237;nicos&#46;</p>"
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;E&#46; Dandy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann J Surg"
                        "fecha" => "1934"
                        "volumen" => "24"
                        "paginaInicial" => "447"
                        "paginaFinal" => "455"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of trigeminal neuralgia by thermocoagulation&#44; glycerolization&#44; and percutaneous compression of the gasserian ganglion and&#47;or retrogasserian rootlets&#58; Longterm results and therapeutic protocol"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Fraioli"
                            1 => "V&#46; Esposito"
                            2 => "B&#46; Guidetti"
                            3 => "G&#46; Cruccu"
                            4 => "M&#46; Manfredi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1989"
                        "volumen" => "24"
                        "paginaInicial" => "239"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2783993"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Concerning the mechanism of trigeminal neuralgia and hemifacial spasm"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;I&#46; Gardner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurosur"
                        "fecha" => "1962"
                        "volumen" => "19"
                        "paginaInicial" => "947"
                        "paginaFinal" => "958"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Needle for use during percutaneous compression of gasserian ganglion for trigeminal neuralgia&#46; Technical note"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;M&#46; Gerber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1989.71.3.0455"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1989"
                        "volumen" => "71"
                        "paginaInicial" => "455"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2788720"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trigeminal compression for tic douloureux&#58; an evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;J&#46; Graf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1963.20.12.1029"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1963"
                        "volumen" => "20"
                        "paginaInicial" => "1029"
                        "paginaFinal" => "1032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14186104"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The anatomy of the gasserian ganglion and the distribution of pain in relation to injections and operations for trigeminal neuralgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;R&#46; Henderson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Roy Coll Surg Eng"
                        "fecha" => "1965"
                        "volumen" => "37"
                        "paginaInicial" => "346"
                        "paginaFinal" => "373"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5849103"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;J&#46; Jannetta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1967"
                        "volumen" => "36"
                        "paginaInicial" => "159"
                        "paginaFinal" => "162"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petrous ridge compression and its surgical correction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;I&#46; Malis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1967.26.1part2.0163"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1967"
                        "volumen" => "26"
                        "paginaInicial" => "163"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6018933"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percutaneous procedures for trigeminal neuralgia&#58; microcompression versus radiofrequency thermocoagulation&#46; Personal experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Meglio"
                            1 => "B&#46; Cioni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1989"
                        "volumen" => "38"
                        "paginaInicial" => "9"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2780067"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Some examples of balloon technology in Neurosurgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Mullan"
                            1 => "E&#46;E&#46; Duda"
                            2 => "N&#46;J&#46; Patronas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1980.52.3.0321"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1980"
                        "volumen" => "52"
                        "paginaInicial" => "321"
                        "paginaFinal" => "329"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7359186"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percutaneous microcompression of the trigeminal ganglion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Mullan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Trigeminal neuralgia"
                        "paginaInicial" => "137"
                        "paginaFinal" => "144"
                        "serieFecha" => "1990"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Mullan"
                            1 => "T&#46; Lichtor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.59.6.1007"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "59"
                        "paginaInicial" => "1007"
                        "paginaFinal" => "1012"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6631493"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autonomic and histopathological effects of percutaneous trigeminal ganglion compression in the rabbit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;C&#46; Preul"
                            1 => "P&#46;B&#46; Long"
                            2 => "J&#46;A&#46; Brown"
                            3 => "M&#46;E&#46; Velasco"
                            4 => "M&#46;T&#46; Weaver"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1990.72.6.0933"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1990"
                        "volumen" => "72"
                        "paginaInicial" => "933"
                        "paginaFinal" => "940"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2338578"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Sarabia&#44; R&#46;&#58; Compresi&#243;n percut&#225;nea del Ganglio de Gasser en el tratamiento de la neuralgia esencial del trig&#233;mino&#46; Madrid&#59; Universidad Complutense de Madrid&#46; 1991&#46; Tesis Doctoral&#46;"
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Compression rather than decompression for trigeminal neuralgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;H&#46; Shelden"
                            1 => "R&#46;H&#46; Pudenz"
                            2 => "D&#46;B&#46; Freshwater"
                            3 => "B&#46;L&#46; Crue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1955.12.2.0123"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1955"
                        "volumen" => "12"
                        "paginaInicial" => "123"
                        "paginaFinal" => "126"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14368343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Results of descompression operation for trigeminal neuralgia four years plus after operation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;J&#46; Svien"
                            1 => "G&#46; Love"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1959.16.6.0653"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1959"
                        "volumen" => "16"
                        "paginaInicial" => "653"
                        "paginaFinal" => "655"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13835958"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controlled thermocoagulation of trigeminal ganglion and rootles for differential destruction of pain fibers&#46; Part 1&#58; Trigeminal neuralgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;H&#46; Sweet"
                            1 => "J&#46;G&#46; Wepsic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1974"
                        "volumen" => "39"
                        "paginaInicial" => "143"
                        "paginaFinal" => "156"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Decompression of the trigeminal root"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Taarnhoj"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1954.11.3.0299"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1954"
                        "volumen" => "11"
                        "paginaInicial" => "299"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13163729"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Decompression of the posterior trigeminal root in trigeminal neuralgia&#58; a 30 year follow-up review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Taarnhoj"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1982.57.1.0014"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1982"
                        "volumen" => "57"
                        "paginaInicial" => "14"
                        "paginaFinal" => "17"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7086492"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fluoroscopy of foramen ovale as an aid to thermocoagulation of the Gasserian Ganglion&#46; Technical note"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;H&#46; Tator"
                            1 => "D&#46;W&#46; Rowed"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1976.44.2.0254"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1976"
                        "volumen" => "44"
                        "paginaInicial" => "254"
                        "paginaFinal" => "257"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1082012"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Vol. 5. Núm. 2.
Páginas 107-114 (enero 1993)
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Vol. 5. Núm. 2.
Páginas 107-114 (enero 1993)
Estudio anatomorradiológico de la técnica de Mullan en el tratamiento de la neuralgia del trigémino
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E. Urculo, L. Martínez, M. Arrazola
Sección de Neurocirugía del Hospital de Guipúzcoa. San Sebastián
MaJ. Aranzadi*, A. Gastaminza*
* Servicio de Anatomía Patológica del Hospital de Guipúzcoa. San Sebastián
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Resumen

Se realiza un estudio anatomorradiológico de la técnica de microcompresión percutánea del nervio trigémino sobre 20 ganglios de Gasser en 10 cadáveres de pacientes fallecidos por causa no neurológica. Se analizan los diferentes pasos técnicos, la morfología radiológica del balón con su correlación anatómica y los efectos del llenado del balón.

Las formas radiológicas del balón más frecuentemente encontradas han sido la redondeada, fusiforme, de pera y de reloj de arena. Todas ellas podemos encontrarlas en un mismo ganglio de Gasser dependiendo del volumen de contraste introducido dentro del balón y de la localización del mismo. Hemos comprobado que la apariencia piriforme característica, es debida en todos los casos, a la protrusión de la punta del globo por el porus trigémini.

Los efectos mecánicos que localmente se producen con la insuflación del balón son nerviosos y durales: se produce una «compresión nerviosa» a nivel del ganglio de Gasser y de la raíz trigeminal, así como una distensión de la duramadre propia y por lo tanto, una verdadera «descompresión dural» que bien pudiera influir en los resultados clínicos.

Summary

We present an anatomical and radiological study of Mullan's technique (percutaneous microcompression of trigeminal nerve), in 20 Gasserian ganglion of 10 fresh cadáver from patients who died of non neurological causes. The surgical technique, balloon's radiological appearance, anatomical correlations and results are discussed.

Most frequently the contour of the balloon has been round, fusiform, or pear or hour-glass shaped. All different shapes may appear while working on the same gasserian ganglion, in relation with the amount of contrast injected or on the placement of the balloon. The typical pear shaped appearance is due to the protrussion of the balloon's tip through the trigeminal porus.

Locally, the mechanical effects of balloon inflation are both neural and dural: on producing «Nervous compression» upon the gasserian ganglion as well as on the trigeminal root, a stretching of the duramater may occur. «Dural decompression» may perhaps play a role on clinical results obtained with the procedure.

Key Words:
Mullan's technique
Percutaneous microcompression
Trigeminal nerve
Trigeminal neuralgia
Anatomy
Palabras Clave:
Microcompresión percutánea
Nervio trigémino
Neuralgia del trigémino
Anatomía

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