Neurovascular compression of the lower cranial nerves:
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| Main Author: | |
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| Format: | Book |
| Language: | English |
| Published: |
Amsterdam [u.a.]
Elsevier
1999
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| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XIX, 271 S. Ill., graph. Darst. |
| ISBN: | 0444829776 |
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| 100 | 1 | |a Hamlyn, Peter J. |e Verfasser |4 aut | |
| 245 | 1 | 0 | |a Neurovascular compression of the lower cranial nerves |c Peter J. Hamlyn |
| 264 | 1 | |a Amsterdam [u.a.] |b Elsevier |c 1999 | |
| 300 | |a XIX, 271 S. |b Ill., graph. Darst. | ||
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| 650 | 4 | |a Cranial Nerve Diseases |x etiology | |
| 650 | 4 | |a Entrapment neuropathies | |
| 650 | 4 | |a Head |x Blood-vessels | |
| 650 | 4 | |a Nerve Compression Syndromes | |
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| adam_text | P.J. Hamlyn, Neumuascular compression of the lower cranial nerves
© 1999 Elsevier Science B.V. All rights reserved
Contents
Acknowledgements vi
Preface to the book vii
List of figures, plates and tables xvii
Part 1. Neurovascular Compression:
Disorders of the Lower Cranial Nerves Anatomy and Technique
Preface 3
1. Review of neurovascular compression in disorders of the lower cranial nerves 5
1. Introduction 5
2. The principle of neurovascular compression 5
3. Historical review 6
4. Evidence for neurovascular compression 7
4.1. Clinical operative data 8
4.2. Clinical radiological data 9
5. Possible mechanisms of symptom production 10
5.1. Cross talk, myelin and the root entry zone 10
5.2. Light and electron microscopy 11
5.3. Neurophysiological studies 11
5.4. The root entry zone 12
5.5. The cause of vascular compression 13
6. Anatomical data 13
6.1. Post mortem studies in patients 13
6.2. Post mortem studies in controls 14
7. The alternative view 15
7.1. Clinical data 15
7.1.1. The therapeutic effect of nerve damage 15
7.1.2. Therapeutic effect of mechanical trauma 15
7.1.3. Placebo 16
7.1.4. Variability of the neurovascular findings on posterior fossa exploration 16
7.1.5. Compression at other sites 16
7.1.6. Other objections 17
7.2. Radiological data 17
8. Alternative theories 17
8.1. Peripheral theories 17
8.2. Central theories 17
9. Alternative treatments 17
10. Conclusion 18
2. Neurovascular compression: difficulties in study design 19
1. Introduction 19
2. Construction of case and control groups 19
3. Estimating the prevalence of disease 20
3.1. Trigeminal neuralgia 20
3.2. Glossopharyngeal neuralgia 21
ix
x Contents
3.3. Intermediate and other facial neuralgia 22
3.4. Hemifacial spasm 22
3.5. Vestibulo cochlear disturbance 22
3.6. Hypertension 23
3.7. Implications 23
4. Conflicts in operative findings in clinical series 24
4.1. Trigeminal neuralgia 25
4.2. Hemifacial spasm 28
4.3. Eighth nerve disorders 30
4.4. Conclusion 30
5. Reasons for conflicting results in clinical series 30
6. Conflicts in anatomical control series 32
6.1. Trigeminal nerve 32
6.2. Facial, cochlear, vestibular and intermediate nerves 32
7. Reasons for conflicting results in control material 33
7.1. Post mortem delay 33
7.2. Preservatives 34
7.3. Perfusion 34
7.4. Dissection method 35
7.5. Matching 35
7.5.1. Age 35
7.5.2. Sex 35
7.5.3. Side 35
7.6. Conclusion 36
8. Classification of neurovascular relationships 36
8.1. Degree of compression 36
8.2. Site of compression 36
9. Conclusions 36
3. Neurovascular anatomy of the lower cranial nerves in health and disease:
considerations of sex, side and age 39
1. Introduction 39
2. Variations with sex in clinical series 39
2.1. Trigeminal neuralgia 39
2.2. Hemifacial spasm 41
2.3. Other conditions 42
3. Variations with side in clinical series 42
3.1. Trigeminal neuralgia 42
3.2. Hemifacial spasm 43
3.3. Other conditions 44
4. Variations with age in clinical series 44
4.1. Trigeminal neuralgia 45
4.1.1. A calculation of the true influence of age on incidence 45
4.2. Hemifacial spasm 47
4.3. Other conditions 47
5. The interrelationship between age, sex and side 48
5.1. Side 48
5.2. Sex 48
5.3. Age 49
6. Variations with side in anatomical series 50
6.1. Arterial 50
6.2. Venous 50
6.3. Nerves 51
6.4. Osteology 51
6.4.1. Jugular foramen 51
6.4.2. Hypoglossal canal 52
6.4.3. Condylar foramen 52
7. Variations with sex and age in anatomical series 52
8. Conclusion 52
4. Study design, dissection methods and measurement in neurovascular relational anatomy 53
1. Introduction 53
2. Study aims 53
3. Study design 54
4. Method, Type I: Comparative patient and cadaver studies 54
Contents xi
4.1. Clinical 55
4.1.1. Patient selection 55
4.1.2. Operative methods 55
4.2. Post mortem 56
4.2.1. Cadaver selection 56
4.2.2. Post mortem method 57
5. Method, Type II: Post mortem studies in grouped cadavers 57
5.1. Cadaver selection 57
5.1.1. Selection 57
5.1.2. Exclusions 57
5.1.3. Matching 58
5.1.4. Numbers 58
5.1.5. Post mortem method 58
6. Classification, measurement and definition 58
6.1. The use of internal comparative ratios 58
6.2. Classification 59
6.2.1. Source of contact/compression 59
6.2.2. Degree of contact/compression 59
6.2.3. Site of contact/compression 59
6.3. Definitions 60
6.4. Measurements 60
7. Statistical methods 60
7.1. Life data 61
7.2. Significance testing 61
8. Summary 61
5. A new method of dynamic in vitro physiological perfusion 63
1. Introduction 63
2. Initial observation and trials without perfusion 63
3. Method 65
4. Results 66
4.1. Cadaver details 66
4.2. Vessel appearances 66
4.3. Vessel pressures with perfusion 67
4.3.1. Arterial 67
4.3.2. Venous 67
4.4. Posterior fossa environment 68
4.4.1. Neurovascular relationships 68
5. Conclusions 68
Part 2. The Trigeminal Nerve: A Clinical and Anatomical Study on Trigeminal Neuralgia
Preface 75
6. Review of trigeminal neuralgia and neurovascular compression of the fifth cranial nerve 77
1. The anatomy of the trigeminal nerve 77
1.1. Sensory pathways 77
1.2. Motor pathways 78
1.3. The nerve root 78
2. Review of trigeminal neuralgia 80
2.1. Definitions 80
2.2. History 80
2.3. Clinical features 82
2.4. Aetiology 83
2.4.1. Secondary trigeminal neuralgia 83
3. Neurovascular decompression in the treatment of primary trigeminal neuralgia 86
4. Alternative treatments for primary trigeminal neuralgia 86
4.1. Medical 87
4.2. Percutaneous methods applied to the gasserian ganglion 87
4.2.1. Percutaneous techniques vs neurovascular decompression 88
4.3. Alternative open techniques 89
4.3.1. Open sectioning of the nerve 89
4.3.2. Physical trauma and decompression at other sites 89
4.4. Other treatments 91
4.4.1. Peripheral nerve treatments 91
xii Contents
4.4.2. Dental treatment 91
5. Summary 92
7. Comparison of the incidence and severity of vascular compression between control cadavers and the
operative observations in trigeminal neuralgia cases 93
1. Introduction 93
2. Clinical study 93
2.1. Clinical series and criteria for inclusion 93
2.2. Operative procedure 94
2.2.1. Study design and method 94
2.2.2. Identification of trigeminal nerve 94
2.2.3. Neurovascular observations 94
2.2.4. Follow up 95
3. Anatomical study 95
3.1. Anatomical series and criteria for inclusion 95
3.1.1. Study design and method 95
3.1.2. Neurovascular observations 95
4. Results 95
4.1. Clinical data 95
4.1.1. Therapeutic procedure 98
4.1.2. Follow up and recurrence of symptoms 99
4.2. Anatomical data 100
5. Discussion 103
5.1. Clinical results 103
5.2. Combined clinical and anatomical results 104
8. The influence of age, sex and side on the relationship between the trigeminal nerve and the vessels of
the posterior fossa 115
1. Introduction 115
2. Anatomical study 115
2.1. Experimental method 115
2.1.1. Analysis 116
2.1.2. Dissection series 116
3. Results 116
3.1. Age 116
3.2. Sex 117
3.3. Side 117
4. Conclusions 118
Part 3. The Neurovascular Relations of the Facial, Cochlear, Vestibular and Intermediate Nerves
Preface 121
9. Review of the basic anatomy and disorders of the facial, cochlear, vestibular and intermediate nerves:
the significance of neurovascular compression 123
1. Introduction 123
2. Review of basic anatomy relating to facial, cochlear, vestibular and intermediate nerves 123
2.1. Facial and intermediate nerves 123
2.1.1. Special visceral efferent (motor root) 124
2.1.2. General visceral efferent 124
2.1.3. Special visceral afferent 125
2.1.4. General somatic afferent 125
2.1.5. The intermediate nerve and its contents 125
2.2. Vestibular nerve 126
2.3. Cochlear nerve 126
2.4. The facial, vestibular, cochlear and intermediate nerves in the cerebellopontine angle and internal auditory
canal: their interrelation and neurovascular relations 126
3. Review of hemifacial spasm and the role of neurovascular compression 127
3.1. Definition 127
3.2. History 127
3.3. Clinical features 127
3.4. Epidemiology 127
3.5. Differential diagnosis 127
3.6. Classification of hemifacial spasm 128
3.6.1. Primary hemifacial spasm 128
Contents xiii
3.6.2. Secondary hemifacial spasm 128
3.7. Primary hemifacial spasm: Theories and aetiology 129
3.7.1. Central 129
3.7.2. Peripheral 129
3.8. Neurovascular compression 130
3.9. The neurophysiology of neurovascular compression in hemifacial spasm 130
3.10. Trauma and decompression in hemifacial spasm 131
3.11. Alternative treatments 133
3.12. Bell s palsy 133
3.13. Overall conclusion 134
4. Review of possible compression syndromes affecting the cochlear and vestibular nerves 134
4.1. History 134
4.2. The literature 134
4.3. Epidemiology 134
4.4. Clinical data 134
5. Review of vascular compression and the intermediate nerve 136
5.1. History 136
5.2. Clinical features and definition 136
5.3. Neurovascular compression in intermediate nerve neuralgia 136
5.4. Conclusions 137
6. Review of anatomical information relating to the facial, cochlear, vestibular and intermediate nerves 137
6.1. Conflicts in studies of the neurovascular relations 137
6.2. Root entry zone and facial, intermediate, cochlear and vestibular nerves 138
6.3. Summary of anatomical results in normals 139
7. Overall conclusions 139
10. A study on the incidence of neurovascular compression of the facial, cochlear, vestibular and
intermediate nerves: the influence of sex, side and age 141
1. Introduction 141
2. An anatomical study 142
2.1. Study method and design 142
3. Results 142
4. Full series 142
4.1. Facial nerve 143
4.2. Cochlear nerve 144
4.3. Vestibular nerve 144
4.4. Intermediate nerve 145
5. The effect of perfusion 145
6. Influence of age, sex and side 146
6.1. Age 146
6.2. Sex 147
6.2.1. Facial nerve 147
6.2.2. Cochlear nerve 147
6.2.3. Vestibular nerve 147
6.2.4. Intermediate nerve 147
6.3. Side 147
6.3.1. Facial nerve 148
6.3.2. Cochlear nerve 148
6.3.3. Vestibular nerve 148
6.3.4. Intermediate nerve 148
6.4. Age, sex and side 148
7. Discussion 148
Part 4. The Neurovascular Relations of the Lowermost Cranial Nerves:
Glossopharyngeal, Vagus, Accessory and Hypoglossal
Preface 159
11. Review of the basic anatomy and disorders of the glossopharyngeal, vagus, accessory and hypoglossal
nerves 161
1. Introduction 161
2. Review of basic anatomy relating to the glossopharyngeal, vagus, cranial accessory and hypoglossal nerve .. 161
2.1. Glossopharyngeal nerve 162
2.1.1. Afferent pathways 162
2.1.2. Efferent pathways 162
xiv Contents
2.1.3. Intracranial course 162
2.1.4. Extracranial course 163
2.2. Vagus nerve 163
2.2.1. Afferent 163
2.2.2. Efferent 164
2.2.3. Intracranial course 164
2.2.4. Extracranial course 164
2.3. Accessory nerve 164
2.3.1. Cranial accessory 164
2.3.2. Spinal accessory 165
2.4. Hypoglossal nerve 165
3. Review of the normal neurovascular anatomy of the glossopharyngeal, vagus, accessory and hypoglossal nerves 166
4. Review of possible neurovascular compression syndromes affecting the glossopharyngeal, vagus, accessory and
hypoglossal nerves 167
4.1. Glossopharyngeal neuralgia and associated conditions 167
4.1.1. History 167
4.1.2. Definition 167
4.1.3. Incidence 168
4.1.4. Epidemiology 168
4.1.5. Clinical features 168
4.1.6. Aetiology 168
4.1.7. Neurovascular compression 169
4.1.8. Alternative treatments 170
4.1.9. Conclusion 170
4.2. Hypertension 171
4.2.1. Theory 171
4.2.2. Clinical data 171
4.2.3. Post mortem 174
4.2.4. Animal models of compression in hypertension 174
4.2.5. Conclusion 175
4.3. Torticollis 176
4.3.1. Theory of neurovascular compression 176
4.3.2. Epidemiology (see chapter 3) 176
4.3.3. Clinical features 176
4.3.4. Neurovascular compression 176
4.3.5. Alternative treatments 179
4.3.6. Conclusions 179
4.4. Hypoglossal nerve dysfunction 179
5. Overall conclusions 180
12. A study of the incidence of neurovascular compression of the glossopharyngeal, vagus, accessory
and hypoglossal nerves: the influence of sex, side and age 181
1. Introduction 181
2. Study design and method 181
3. Results 183
3.1. Full series 183
3.2. Glossopharyngeal nerve 183
3.3. Vagus nerve 184
3.4. Accessory nerve 185
3.5. Hypoglossal nerve 185
4. The effect of perfusion 185
5. The influence of age, sex and side 186
5.1. Age 186
5.2. Sex 187
5.3. Side 187
6. Discussion 188
Part 5. Neurovascular Compression: Current Status and Future Challenges
Preface 197
13. Neurovascular compression: current status and future challenges 199
1. Introduction 199
2. New anatomical methods 200
3. The neurovascular compression theory; its anatomical foundations 201
Contents xv
3.1. Trigeminal neuralgia 201
3.2. Hemifacial spasm 201
3.3. Tinnitus and vertigo 202
3.4. Glossopharyngeal and intermediate nerve neuralgia 202
3.5. Hypertension 203
3.6. Torticollis 203
3.7. The hypoactive syndromes 203
3.8. The incidence of disease 204
3.9. Epidemiological patterns 204
4. Current status of neurovascular decompression 205
5. Recent advances 207
5.1. Magnetic resonance imaging 207
5.2. Other developments 209
6. Future challenges 210
6.1. Further development of noninvasive investigations 210
6.2. Effective clinical trials 210
6.3. Epidemiology 211
6.4. Standards of reporting 211
6.5. New methods of decompression 211
Appendix 1. Data from literature review 213
1. Introduction 213
2. Methods 213
2.1. Reference numbering 214
3. The literature 214
3.1. Trigeminal neuralgia 214
3.2. Hemifacial spasm 215
3.3. Eighth nerve disorders 215
4. Results 215
4.1. Trigeminal neuralgia 215
4.2. Hemifacial spasm 215
4.3. Eighth nerve disorders 216
5. Tables 216
6. References for Appendix 1 226
References 235
Subject index 265
P.J. Hamlyn, Neurovascular compression of the lower cranial nerves
© 1999 Elsevier Science B.V All rights reserved
List of figures, plates and tables
Chapter 1
Fig. 1. Distance in mm from the brain stem of the interface between peripheral and central myelin for the lower
cranial nerves 12
Table 1. Literature reports investigating presence of anterior inferior cerebellar artery (AICA) loops within the
internal auditory canal (IAC) 14
Chapter 2
Fig. 1. Percentage of trigeminal neuralgia cases in which no significant vessel was found compressing the nerve
at exploration 25
Fig. 2. Percentage of negative explorations in trigeminal neuralgia arranged in order of series size 26
Fig. 3. Percentage of negative explorations in cases of trigeminal neuralgia arranged in ascending order of
percentages 26
Fig. 4. Percentage of those vessels found which were identified as arteries in 24 series of trigeminal neuralgia
cases from the literature 26
Fig. 5. Percentage of those vessels found which were identified as veins in 24 series of trigeminal neuralgia
cases from the literature 27
Fig. 6. Percentage of those vessels found which were identified as being a mixed combination of veins and
arteries in 24 series of trigeminal neuralgia cases from the literature 27
Fig. 7. Percentage identified as AICA of those vessels which were either SCA or AICA, in 12 series of
trigeminal neuralgia which clearly identified the vessels involved 28
Fig. 8. Percentage in 16 series of hemifacial spasm cases in which no significant vessel was found 28
Fig. 9. Percentage of cases in which the vessel found was venous in series of hemifacial spasm 29
Fig. 10. Percentage of cases in which an artery was identified as the PICA when it was either the PICA or the
AICA 29
Fig. 11. Mean age as given in 54 series of trigeminal neuralgia patients 31
Fig. 12. Mean age as given in 36 series of hemifacial spasm patients 31
Chapter 3
Fig. 1. Predominance of females in 77 series of patients seeking treatment for trigeminal neuralgia 40
Fig. 2. Predominance of females in 40 series of patients seeking treatment for hemifacial spasm 41
Fig. 3. Predominance of right sided cases among patients seeking treatment for trigeminal neuralgia 43
Fig. 4. Predominance of left sided cases in patients seeking treatment for hemifacial spasm 44
Fig. 5. Percentage of population falling within the decades for the population of England and Wales in 1935,
1965 and 1985 46
Fig. 6. Age adjusted and crude rates of incidence for patients seeking treatment for trigeminal neuralgia 47
Table 1. Age distribution of cases of trigeminal neuralgia from five series from the literature 45
Table 2. Relationship between sex side distribution and incidence of trigeminal neuralgia in 6 studies from
the literature in addition to the present cases (total cases 820) 49
Chapter 4 (no figures/plates/tables)
Chapter 5
Fig. 1. Illustration of the arterial perfusion and monitoring method 64
Fig. 2. Illustration of the venous perfusion and monitoring method 65
Plate 1. Appearance of vessels prior to perfusion 69
Plate 2. Appearance of the posterior fossa following perfusion 70
Plate 3. Change in vessels following perfusion 71
Table 1. Sites and side monitored during perfusion study in 16 cadavers 66
Table 2. Change in the distance between brain stem and cranial wall with perfusion 67
xvii
xviii List of figures, plates and tables
Chapter 6
Plate 1. Secondary trigeminal neuralgia; MRI scan showing the case of a 63 year old female with right trigeminal
pain 84
Plate 2. Secondary trigeminal neuralgia; MRI scan demonstrating a further case of trigeminal schwannoma .. 84
Plate 3. Secondary trigeminal neuralgia; operative appearance 85
Chapter 7
Fig. 1. Source and site of compression in relation to the recurrence of symptoms in 37 patients undergoing
decompression 100
Fig. 2. Number and identity of vessels in contact with or near to the trigeminal nerve in 35 control cadavers 101
Fig. 3. Change in the incidence of vessels in contact with or near to the trigeminal nerve in 35 cadavers with
perfusion of venous and arterial systems to physiological pressures 102
Plate 1. Neurovascular compression in a patient with trigeminal neuralgia and its treatment 105
Plate 2. Two cases of neurovascular decompression in patients with trigeminal neuralgia 106
Plate 3. A further three cases of neurovascular compression in patients with trigeminal neuralgia 107
Plate 4. Dissection of the trigeminal nerve in trigeminal neuralgia 108
Plate 5. Arterial grooving of the trigeminal nerve at the root entry zone in trigeminal neuralgia 109
Plate 6. Trigeminal nerve findings with perfusion in three control cadavers 110
Plate 7. Right trigeminal nerve of a control cadaver before and during perfusion Ill
Plate 8. Right trigeminal nerve of a control cadaver before and during perfusion 112
Plate 9. Neurovascular relationships of the left trigeminal nerve in two cadavers 113
Plate 10. Change in vessels with perfusion 114
Table 1. Neurovascular relationships in the 42 cases in which vascular contact occurred at the root entry zone
and lateral to the root entry zone 96
Table 2. Distribution of pain and the aspect of the nerve on which the vessels fell in the 46 trigeminal neuralgia
cases 98
Table 3. Comparative figures for number of vessels and their identity in contact with, or near to the trigeminal
nerve from the clinical and anatomical groups 102
Table 4. Age, side and sex distribution of cadavers in relation to whether vessels were remote, near and in contact
with the trigeminal nerve 103
Chapter 8
Table 1. Details of the neurovascular relationships of the trigeminal nerve in cadavers from older and younger
groups and those of different sex and side 117
Chapter 9 (no figures/plates/tables)
Chapter 10
Fig. 1. Effect of perfusion on grooving at the root entry zone for the facial, vestibular and cochlear nerves.. 145
Plate 1. Neurovascular relationships of the VII and VIII cranial nerve on the right side 151
Plate 2. Neurovascular relationships of the VII and VIII cranial nerve bundle in two cadavers 152
Plate 3. Intermediate fibres in the VII and VIII nerve bundle of a cadaver 153
Plate 4. Neurovascular relationships of the intermediate fibres in a cadaver before and during perfusion 154
Plate 5. Neurovascular relations of the seventh and eighth nerves in cadavers 155
Plate 6. Neurovascular compression in a case of hemifacial spasm 156
Table 1. Details of the neurovascular contacts of the facial, cochlear, vestibular and intermediate nerves in the
full series of 63 cadavers 143
Table 2. Number and percentage in which simple contact at both the root entry zone (REZ) and laterally, and
also grooving at the root entry zone of the facial, cochlear, vestibular and intermediate nerves altered
with perfusion 146
Table 3. Cases of vascular contacts and grooves at the root entry zone and lateral to the root entry zone of the
facial, cochlear, vestibular and intermediate nerves in the particular age, sex and side groups 149
Chapter 11 (no figures/plates/tables)
Chapter 12
Fig. 1. Illustration of the definition employed in the classification of rootlets as being not under tension or
under tension 182
Plate 1. Neurovascular relationships of the rootlets of the lowermost cranial nerves in two cadavers 190
Plate 2. Effect of perfusion on the neurovascular relationships of the rootlets of the lowermost cranial nerves in
a cadaver 191
Plate 3. Relationship between the vertebral artery and the accessory nerve in a cadaver 192
Plate 4. Neurovascular relationships of the lowermost cranial nerves in two cadavers 193
Table 1. Cases of neurovascular contacts of the glossopharyngeal, vagus, cranial and spinal accessory and
hypoglossal nerves 183
!
List of figures, plates and tables xix
Table 2. Percentages of dissections in which there was contact or contact with tension at the root entry zone or
laterally or just at the root entry zone in the 63 cadavers 184
Table 3. Types of vessel involved in the contacts between the glossopharyngeal, vagus, accessory and hypoglossal
nerve rootlets in the total series of 63 dissections 184
Table 4. Effect of perfusion on the neurovascular relationships of the glossopharyngeal, vagus, accessory and
hypoglossal nerve rootlets 186
Table 5. Summary of the number of cases of vascular contacts and consequent signs of tension at the root entry
zone and lateral to the root entry zone of the glossopharyngeal, vagus, accessory and hypoglossal nerve
rootlets in the particular age, sex and side groups 187
Chapter 13
Plate 1. Neurovascular compression and MRI 208
Plate 2. Relationships of the cranial nerves observed operatively from their medial aspect 212
Table 1. Disorders proposed to be associated with neurovascular compression 205
Table 2. Current status of neurovascular compression in disorders of the lower cranial nerves 206
Table 3. Proposed peripheral neurovascular compression syndromes 207
Appendix 1
Table 1. Data from trigeminal neuralgia series 218
Table 2. Data from hemifacial spasm series 222
Table 3. Data from vestibulocochlear series 224
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| id | DE-604.BV012553632 |
| illustrated | Illustrated |
| indexdate | 2024-07-09T18:29:34Z |
| institution | BVB |
| isbn | 0444829776 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-008523632 |
| oclc_num | 41454778 |
| open_access_boolean | |
| owner | DE-355 DE-BY-UBR |
| owner_facet | DE-355 DE-BY-UBR |
| physical | XIX, 271 S. Ill., graph. Darst. |
| publishDate | 1999 |
| publishDateSearch | 1999 |
| publishDateSort | 1999 |
| publisher | Elsevier |
| record_format | marc |
| spelling | Hamlyn, Peter J. Verfasser aut Neurovascular compression of the lower cranial nerves Peter J. Hamlyn Amsterdam [u.a.] Elsevier 1999 XIX, 271 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Druk gtt Hersenzenuwen gtt Zenuwbeschadiging gtt Blood Vessels Cranial Nerve Diseases etiology Entrapment neuropathies Head Blood-vessels Nerve Compression Syndromes Nerves, Cranial Hirnnerv (DE-588)4025025-8 gnd rswk-swf Neurovaskuläres Kompressionssyndrom (DE-588)4410072-3 gnd rswk-swf Hirnnerv (DE-588)4025025-8 s Neurovaskuläres Kompressionssyndrom (DE-588)4410072-3 s DE-604 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008523632&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Hamlyn, Peter J. Neurovascular compression of the lower cranial nerves Druk gtt Hersenzenuwen gtt Zenuwbeschadiging gtt Blood Vessels Cranial Nerve Diseases etiology Entrapment neuropathies Head Blood-vessels Nerve Compression Syndromes Nerves, Cranial Hirnnerv (DE-588)4025025-8 gnd Neurovaskuläres Kompressionssyndrom (DE-588)4410072-3 gnd |
| subject_GND | (DE-588)4025025-8 (DE-588)4410072-3 |
| title | Neurovascular compression of the lower cranial nerves |
| title_auth | Neurovascular compression of the lower cranial nerves |
| title_exact_search | Neurovascular compression of the lower cranial nerves |
| title_full | Neurovascular compression of the lower cranial nerves Peter J. Hamlyn |
| title_fullStr | Neurovascular compression of the lower cranial nerves Peter J. Hamlyn |
| title_full_unstemmed | Neurovascular compression of the lower cranial nerves Peter J. Hamlyn |
| title_short | Neurovascular compression of the lower cranial nerves |
| title_sort | neurovascular compression of the lower cranial nerves |
| topic | Druk gtt Hersenzenuwen gtt Zenuwbeschadiging gtt Blood Vessels Cranial Nerve Diseases etiology Entrapment neuropathies Head Blood-vessels Nerve Compression Syndromes Nerves, Cranial Hirnnerv (DE-588)4025025-8 gnd Neurovaskuläres Kompressionssyndrom (DE-588)4410072-3 gnd |
| topic_facet | Druk Hersenzenuwen Zenuwbeschadiging Blood Vessels Cranial Nerve Diseases etiology Entrapment neuropathies Head Blood-vessels Nerve Compression Syndromes Nerves, Cranial Hirnnerv Neurovaskuläres Kompressionssyndrom |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008523632&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT hamlynpeterj neurovascularcompressionofthelowercranialnerves |