The Role Of Hemodynamic Factors In Primary Trigeminal Neuralgia

Objective The hemodynamic changes of the blood vessels responsible for primary trigeminal neuralgia were analyzed using the computational fluid dynamics software,and to explore its role in primary trigeminal neuralgia.Methods A total of 30 patients with primary trigeminal neuralgia who underwent microvascular decompression in our hospital from January 2018 to October 2020 were collected as pain group,and 15 asymptomatic patients with neurovascular compression were found by neuroimaging examination in the same period as non-pain group.The imaging data of the two groups were imported into 3DSlicer software for threedimensional volume reconstruction,neurovascular model was established,and using a picture protractor to measure the bending angle of two groups of blood vessels.The regions of neurovascular compression,proximal and distal regions of the two groups were marked,and the established vascular geometric model was imported into the Fluent module of the ANSYS software.The two groups of simulated blood vessels were cut,meshed,calculated and solved.The results of the solution were imported into the CFD-Post module of the ANSYS software to view the distribution cloud maps of the wall shear force and wall pressure of the two groups of blood vessels.The data obtained from the two groups of blood vessels were statistically analyzed by SPSS26.0 software.Results 1.In pain group,the bending angle of responsible vessels was negatively correlated with the wall shear force in the area of neurovascular compression,proximal region and distal region(P < 0.05),and also negatively correlated with the wall pressure in neurovascular compression area(P < 0.05).There was no significant correlation between the bending angle of responsible vessels and the wall pressure in the proximal and distal areas of neurovascular compression(P > 0.05).In the non-pain group,there was no significant correlation between the bending angle of blood vessels and the wall shear force and wall pressure in the area of neurovascular compression,proximal region and distal region(P > 0.05).In the pain group,there was a significant difference in the wall shear force and wall pressure between the neurovascular compression area and the proximal region and the distal region(P < 0.05),and there was a significant difference between the proximal region and the distal region(P < 0.05),in the pain group,the wall shear force and wall pressure in the area of neurovascular compression were higher than those in the proximal region and distal region,and the wall shear force in the proximal region was higher than that in the distal region.There was no significant difference between the proximal region and the distal region(P > 0.05).There was no significant difference in wall shear force and wall pressure between the non-pain group and the non-pain group(P > 0.05).3.The wall shear force and wall pressure in the neurovascular compression area,proximal region and distal region in the pain group were significantly different from those in the non-pain group(P < 0.05).The wall shear force and wall pressure in the neurovascular compression area,proximal region and distal region in the pain group were higher than those in the non-pain group.Conclusion 1.There are specific hemodynamic characteristics in the area of neurovascular compression of primary trigeminal neuralgia.2.The effectiveness of microvascular decompression in the treatment of primary trigeminal neuralgia may be related to the change of the blood flow direction of responsible blood vessels and the force on the wall of blood vessels.