Tag: Smoking

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Tobacco Use and Trigeminal Neuralgia: Clinical Features and Outcome After Microvascular Decompression

Neurosurgery 96:667–672, 2025

• Tobacco use affects trigeminal neuralgia (TN) outcomes: Smokers with TN tend to develop symptoms at a younger age and have worse long-term outcomes after microvascular decompression (MVD) surgery compared to nonsmokers.

• Smokers show more widespread facial pain: TN in smokers is associated with a more widespread distribution of facial pain, suggesting a more severe form of the disease.

• Immediate postoperative outcomes similar: There is no significant difference in immediate postoperative outcomes between smokers and nonsmokers, although smokers are less likely to be pain-free in the long term.

• Potential benefits of smoking cessation: Patients with a remote history of smoking have outcomes similar to those who never smoked, indicating potential benefits of quitting smoking before surgery.

• Study limitations: The study is a single-center retrospective analysis and may not be generalizable to all TN patients or those undergoing different treatments.

• Implications for treatment: Findings suggest the need for presurgical counseling and support for smoking cessation to improve outcomes for TN patients undergoing MVD.

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Smoking and Intracranial Aneurysm Morphology

Smoking and aneurysms

Neurosurgery 77:59–66, 2015

Smoking is a well-known independent risk factor for both aneurysm formation and rupture. There is mounting evidence that aneurysm morphology beyond size can have a significant role in aneurysm formation and rupture risk by its effects on aneurysmal hemodynamics.

OBJECTIVE: To study the variation in aneurysm morphology between smokers and nonsmokers and delineate how changes in these factors might affect aneurysm formation and rupture.

METHODS: We generated 3-dimensional models of aneurysms and their surrounding vasculature by analyzing preoperative computed tomography angiograms with Slicer software. We then examined the association between smoking status and intrinsic, transitional, and extrinsic aspects of aneurysm morphology in both univariate and multivariate statistical analyses.

RESULTS: From 2005 to 2013, 199 cerebral aneurysms in never smokers and current smokers were evaluated/treated at a single institution with available computed tomography angiograms (102 in never smokers and 97 in current smokers). Multivariate analysis of current smokers vs never smokers demonstrated that aneurysms in current smokers were significantly associated with multiple aneurysms (odds ratio [OR]: 2.15, P = .03), larger daughter vessel diameters (OR: 3.13, P = .01), larger size ratio (OR: 1.78, P = .01), and location at the basilar apex (OR: 6.26, P = .02).

CONCLUSION: The differences in aneurysm morphology between smoking and nonsmoking patient populations may elucidate the effects of smoking on aneurysm formation and eventual rupture. We identified several aspects of aneurysm morphology significantly associated with smoking status that may provide the morphological basis for how smoking leads to increased aneurysm rupture.

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