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Patent foramen ovale (PFO) is closely related to neurological diseases such as stroke, migraine, obstructive sleep apnea syndrome (OSAS) and decompression sickness (DCS). It has been suggested that PFO closure could be effectively prevent and treat these neurological diseases. This article focus on exploration of the pathogenesis, epidemiology and clinical characteristics of neurological diseases related to PFO, and to discuss the potential complexity and future development of PFO closure for the treatment of these diseases. The aim is to provide guidance for the diagnosis and treatment of neurological diseases related to PFO. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical efficacy and application value of an improved 3D-printed guide plate for the treatment of primary trigeminal neuralgia (PTN) by percutaneous microballoon compression (PMC). Methods This prospective study included 42 patients with primary trigeminal neuralgia treated at the Department of Stomatology, Xuzhou Central Hospital, from September 2019 to January 2022. The group was divided by the random number table method into the experimental group (adopting 3D printing technology to make guide plates to guide the puncture, 22 cases) and the control group (adopting the traditional Hartel anterior approach to position the puncture, 20 cases). The intraoperative success rate of the first puncture, puncture time, operative time, radiation exposure of patients and postoperative complications were compared between the two groups. Postoperative Barrow Neurological Institute Scale (BNI) scores, facial numbness, diminished corneal reflexes and chewing weakness were recorded. The t-test, rank-sum test and chi-square test were used for statistical analysis, with P0.05). In the experimental group, 16 patients had postoperative masseter weakness, 1 had keratitis and 10 had perilabial herpes, while in the control group, 18 patients had postoperative masseter weakness, 2 had keratitis, 11 had perilabial herpes and 1 had monocular blindness. There was no significant difference in postoperative complications between the two groups (P>0.05). At 12 months of follow-up, there was no recurrence in either the experimental or control group. Conclusions 3D digital guide plate-guided percutaneous microballoon compression for primary trigeminal neuralgia can improve the accuracy and safety of puncture to a certain extent, obviously shorten the operation time, reduce radiation exposure of the patients, improve the success rate of the operation, meaning it has a high clinical application value.

Migraine is a common neuro⁃vascular disease with a global prevalence of about 15% and a heavy burden. Patent foramen ovale (PFO) is the most common congenital cardiac abnormality consisting of the main cause of right⁃to⁃left shunt (RLS). There is a correlation between PFO and migraine, especially migraine with aura (MA). The comorbidity rate of PFO and migraine is significantly higher than that of the general population. The exact pathophysiological mechanism of comorbidity between PFO and migraine is unclear. At present, it is considered that paradoxical embolism and vasoactive peptides may underlie this comorbidity. Some studies suggest that percutaneous closure of PFO can reduce the frequency and duration of migraine, but the effectiveness of closure of PFO is still controversial. At present, limited evidence suggests that migraine with aura, antiplatelet drugs, large amount of RLS, and comorbid with ischemic stroke and transient ischemic attack (TIA) may benefit more from closure of PFO. In the future, more multicenter, prospective, double⁃blind, randomized controlled large⁃scale clinical studies are needed to clarify the long⁃term efficacy and predictive factors of closure of PFO on migraine prophylactic treatment, so as to provide criteria for screening the eligible patients treated with closure of PFO.

Trigeminal neuralgia (TN) is a common headache or orofacial pain, which can be divided into idiopathic TN, classical TN and secondary TN. Minimally invasive intervention is an important treatment method for idiopathic TN and classical TN. Percutaneous foramina ovale puncture of semilunar ganglion is a classic approach for minimally invasive interventional of TN, and improving the success rate of puncture is an important link to ensure curative effect and reduce complications. There are a variety of puncture guidance methods in clinical operation. In this paper, relevant literature on different puncture guidance methods of transcutaneous skull base foramina ovale for TN in recent years was reviewed to provide reference for minimally invasive interventional treatment of TN. [ABSTRACT FROM AUTHOR]

Migraine is a common clinical chronic neurovascular disease, which seriously affects the quality of life of patients. Studies have shown that patent foramen ovale (PFO) may be related to migraine, such as transient hypoxemia caused by patent foramen ovale related right ⁃ to ⁃ left shunt, or vasoactive substances passing through an unclosed oval foramen, avoiding lung tissue metabolism and directly entering the arterial system, and contradictory micro ⁃ embolism and other mechanisms may be related to migraines related to patent foramen ovale, especially migraine with aura. The closure of patent foramen ovale can benefit some migraine patients. This article intends to outline the relationship between patent foramen ovale and migraine, and its mechanism, prevention and treatment.

Objectives: Primary trigeminal neuralgia (PTN) is a common cranial nerve disease in neurosurgery, which seriously endangers the physical and mental health of patients. Percutaneous balloon compression (PBC) has become an effective procedure for the treatment of PTN by blocking pain conduction through minimally invasive puncture. However, the recurrence of facial pain after PBC is still a major problem for PTN patients. Intraoperative balloon shape, pressure and compression time can affect the prognosis of patients with PBC after surgery. The foramen ovale size has an effect on the balloon pressure in Meckel's lumen. This study aims to analyse the predictive value of foramen ovale size for postoperative pain recurrence of PBC by exploring the relationship between foramen ovale size and postoperative pain recurrence of PBC., Methods: A retrospectively analysis was conducted on the clinical data of 60 patients with PTN who were treated with PBC in Department of Neurosurgery, Affiliated Hospital of Chengde Medical College from November 2018 to December 2021. We followed-up and recorded the Barrow Neurological Institute (BNI) pain score at 1, 3, 6 and 12 months after operation. According to the BNI pain score at 12 months after surgery, the patients were divided into a cure group (BNI pain score I to Ⅱ) and a recurrence group (BNI pain score Ⅲ to Ⅴ). The long diameter, transverse diameter and area of foramen ovale on the affected side and the healthy side of the 2 groups were measured. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used for analysis the relationship between the recurrence of pain and the long diameter, transverse diameter, area of foramen ovale on the affected side, and aspect ratio, transverse diameter ratio, area ratio of foramen ovale on the affected side to healthy side in the 2 groups., Results: At the end of 12 months of follow-up, 50 (83.3%) patients had pain relief (the cured group), 10 (16.7%) patients had different degrees of pain recurrence (the recurrence group), and the total effective rate was 83.3%. There were no significant differences in preoperative baseline data between the 2 groups (all P >0.05). The long diameter of foramen ovale on the affected side, the long diameter ratio and area ratio of foramen ovale on the affected/healthy side in the cured group were significantly higher than those in the recurrence group (all P <0.05), and there were no significant differences in the transverse diameter and area of foramen ovale on the affected side and the transverse diameter ratio of foramen ovale on the affected/healthy side between the 2 groups (all P >0.05). The ROC curve analysis showed that the AUC of the long diameter of foramen ovale on the affected side was 0.290 (95% CI 0.131 to 0.449, P =0.073), and the AUC of aspect ratio of foramen ovale on the affected side to healthy side was 0.792 (95% CI 0.628 to 0.956, P =0.004). The AUC of area ratio of foramen ovale on the affected side to healthy side was 0.766 (95% CI 0.591 to 0.941, P =0.008), indicating that aspect ratio and area ratio of foramen ovale on the affected side to healthy side had a good predictive effect on postoperative pain recurrence of PBC. When aspect ratio of foramen ovale on the affected side to healthy side was less than 0.886 3 or area ratio of foramen ovale on the affected side to healthy side was less than 0.869 4, postoperative pain recurrence was common., Conclusions: Accurate evaluation of the foramen ovale size of skull base before operation is of great significance in predicting pain recurrence after PBC.

Migraine is a kind of common primary headache, which seriously damages human health and quality of life. Recent studies show there is a high incidence of white matter lesions (WML) in migraineurs, which is independent of other risk factors for cerebrovascular diseases. The patent foramen ovale (PFO) in migraineurs, especially in migraineurs with aura, is more common than in general population. There is a close relationship between them, but it is controversial whether it is a causal link. Patent foramen ovale can cause paradoxical embolism, but its role in the pathogenesis of migraine is still unknown. It is worth exploring whether there is difference in white matter lesions between the migraineurs with and without patent foramen ovale. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between the anatomic parameters of foramen ovale and intraluminal pressure during percutaneous balloon compression (PBC) in the treatment of primary trigeminal neuralgia. Methods: Twenty patients diagnosed with primary trigeminal neuralgia in the Department of Pain Medicine of the Third Xiangya Hospital, Central South University between November 2020 and April 2021 were enrolled. Three-dimensional (3D) high-resolution CT reconstruction of skull base was performed preoperatively to evaluate the parameters of foramen ovale. The intraluminal balloon pressure was continuously recorded during the PBC procedure. Correlation analysis was conducted between intraluminal pressure and foramen ovale parameters. Results: Eighteen patients had complete pain relief, 1 had obvious relief, and 1 had partial relief after PBC. The maximum cross-sectional length of the foramen ovale was (7.8±1.7) mm. The peak intraluminal pressure (P M ) during PBC was (194±27) kPa. The intraluminal pressure was (164±28) kPa at initial compression (P 0 ), and (135±20) kPa after compression for 120 seconds respectively. Correlation analysis showed that the P 0 was positively and significantly correlated with the length of foramen ovale ( r =0.56, P <0.05), but not with the width of foramen ovale ( r =0.24, P >0.05), the area of foramen ovale ( r =0.36, P >0.05) and the degree of balloon filling ( r =-0.09, P >0.05). Similarly, P 120 was significantly correlated with the length of foramen ovale ( r =0.54, P <0.05). No significant correlation was observed between P 120 and the width of the foramen ovale ( r =0.18, P >0.05), the area of the foramen ovale ( r =0.28, P >0.05) or the width of balloon filling ( r =-0.13, P >0.05). Conclusions: The length of foramen ovale correlates with the intraluminal pressure during PBC procedure in trigeminal neuralgia patients. Parameters of foramen ovale obtained via preoperative high-resolution CT reconstruction of skull base may provide reference for predicting targeted intraluminal balloon pressure during PBC.