Abstract：
UNASSIGNED: The culprit of trigeminal neuralgia (TGN) may occur at any point between the nerve\'s root entry zone (REZ) and Meckel\'s cave. Meckel\'s cave meningoencephaloceles are rare middle cranial fossa defects that usually remain asymptomatic but may contain prolapsed trigeminal nerve rootlets and result in TGN. Their management and surgical outcomes remain poorly understood.
UNASSIGNED: To perform a systematic review of clinical presentation and surgical outcomes of middle fossa defects presenting with trigeminal nerve-related symptoms.
UNASSIGNED: A systematic review was conducted in accordance with the PRISMA guidelines for all reports of middle cranial fossa defects causing trigeminal nerve-related symptoms. The pathophysiology, presentation, surgical management, and outcomes are discussed and illustrated with a case.
UNASSIGNED: Initial search from inception to March 2021 identified 33 articles for screening. After applying inclusion and exclusion criteria, 6 articles were included representing a total of 8 cases in addition to our case (n = 9). All 9 patients were females and 33.3% (n = 3) presented with classic trigeminal neuralgia. \"Empty sella\" syndrome and radiologic signs of intracranial hypertension were present in 40%-62%. No patient presented with cerebrospinal fluid leak. The preferred treatment modality was surgical with subtemporal extradural repairs using combinations of autologous fat and muscle grafts and synthetic dura. Postoperative outcomes were only available in 55.5% (n = 5) of the cases, and nearly all reported complete symptom resolution, except for one case in which the meningoencephalocele wall was incised, along with trigeminal rootlets adhered to it. Our patient had immediate and durable symptom relief after a 4-year follow-up.
UNASSIGNED: MEC containing prolapsed trigeminal nerve rootlets can cause typical trigeminal neuralgia from chronic pulsatile stress. This supports the hypothesis that the compressive or demyelinating culprit can locate more ventrally on the course of the trigeminal nerve. Subtemporal extradural surgical repairs can be safe, effective, and durable. Incising the MEC wall should be avoided as it may have trigeminal rootlets adhered to it.
UNASSIGNED: To perform a systematic review of clinical presentation and surgical outcomes of middle fossa defects presenting with trigeminal nerve-related symptoms.
UNASSIGNED: A systematic review was conducted in accordance with the PRISMA guidelines for all reports of middle cranial fossa defects causing trigeminal nerve-related symptoms. The pathophysiology, presentation, surgical management, and outcomes are discussed and illustrated with a case.
UNASSIGNED: Initial search from inception to March 2021 identified 33 articles for screening. After applying inclusion and exclusion criteria, 6 articles were included representing a total of 8 cases in addition to our case (n = 9). All 9 patients were females and 33.3% (n = 3) presented with classic trigeminal neuralgia. \"Empty sella\" syndrome and radiologic signs of intracranial hypertension were present in 40%-62%. No patient presented with cerebrospinal fluid leak. The preferred treatment modality was surgical with subtemporal extradural repairs using combinations of autologous fat and muscle grafts and synthetic dura. Postoperative outcomes were only available in 55.5% (n = 5) of the cases, and nearly all reported complete symptom resolution, except for one case in which the meningoencephalocele wall was incised, along with trigeminal rootlets adhered to it. Our patient had immediate and durable symptom relief after a 4-year follow-up.
UNASSIGNED: MEC containing prolapsed trigeminal nerve rootlets can cause typical trigeminal neuralgia from chronic pulsatile stress. This supports the hypothesis that the compressive or demyelinating culprit can locate more ventrally on the course of the trigeminal nerve. Subtemporal extradural surgical repairs can be safe, effective, and durable. Incising the MEC wall should be avoided as it may have trigeminal rootlets adhered to it.
摘要：
■三叉神经痛（TGN）的罪魁祸首可能发生在神经\的根部进入区（REZ）和Meckel\的洞穴之间的任何位置。Meckel的洞穴脑膜脑囊肿是罕见的中颅窝缺损，通常无症状，但可能包含脱垂的三叉神经小根并导致TGN。他们的管理和手术结果仍然知之甚少。
■对表现为三叉神经相关症状的中窝缺损的临床表现和手术结果进行系统评价。
■根据PRISMA指南对导致三叉神经相关症状的中颅窝缺损的所有报告进行了系统评价。病理生理学，介绍,手术管理,并通过一个案例对结果进行了讨论和说明。
■从开始到2021年3月的初始搜索确定了33篇文章进行筛选。在应用纳入和排除标准后，除我们的病例外，共纳入6篇文章，共8例(n=9)。所有9例患者均为女性，其中33.3％（n=3）出现经典三叉神经痛。“空蝶鞍”综合征和颅内高压的放射学征象占40％-62％。无患者出现脑脊液漏。首选的治疗方式是使用自体脂肪和肌肉移植物以及合成硬脑膜的组合进行颞下硬膜外修复。术后结果仅在55.5％（n=5）的病例中可用，几乎所有人都报告了完全的症状缓解，除了一例脑膜脑膨出壁被切开，和三叉神经的小根一起粘附在它上面。经过4年的随访，我们的患者症状得到了立即和持久的缓解。
■含有脱垂三叉神经根的MEC可引起典型的三叉神经痛，原因是慢性搏动性应激。这支持以下假设：压迫性或脱髓鞘的罪魁祸首可以更多地位于三叉神经的腹侧。颞下硬膜外手术修复是安全的，有效,和耐用。应避免切开MEC壁，因为它可能附着有三叉神经根。
■对表现为三叉神经相关症状的中窝缺损的临床表现和手术结果进行系统评价。
■根据PRISMA指南对导致三叉神经相关症状的中颅窝缺损的所有报告进行了系统评价。病理生理学，介绍,手术管理,并通过一个案例对结果进行了讨论和说明。
■从开始到2021年3月的初始搜索确定了33篇文章进行筛选。在应用纳入和排除标准后，除我们的病例外，共纳入6篇文章，共8例(n=9)。所有9例患者均为女性，其中33.3％（n=3）出现经典三叉神经痛。“空蝶鞍”综合征和颅内高压的放射学征象占40％-62％。无患者出现脑脊液漏。首选的治疗方式是使用自体脂肪和肌肉移植物以及合成硬脑膜的组合进行颞下硬膜外修复。术后结果仅在55.5％（n=5）的病例中可用，几乎所有人都报告了完全的症状缓解，除了一例脑膜脑膨出壁被切开，和三叉神经的小根一起粘附在它上面。经过4年的随访，我们的患者症状得到了立即和持久的缓解。
■含有脱垂三叉神经根的MEC可引起典型的三叉神经痛，原因是慢性搏动性应激。这支持以下假设：压迫性或脱髓鞘的罪魁祸首可以更多地位于三叉神经的腹侧。颞下硬膜外手术修复是安全的，有效,和耐用。应避免切开MEC壁，因为它可能附着有三叉神经根。
