Clinical outcome following micro-vascular decompression for trigeminal neuralgia

Godugu Bhaskar Rao, Sharath Kumar Maila, Akyam Lakshman Rao, Ambarapu Mastan Reddy


Background: Trigeminal neuralgia is the most common facial pain syndrome characterized by severe, brief recurrent episodes of electric shock like pain in the distribution of one or more branches of trigeminal nerve on one side of the face. In the present paper we present our experience with MVD for trigeminal neuralgia in a series of 20 patients during the last 4 years.

Methods: All the patients presented to the neurosurgery department with features suggestive of Trigeminal Neuralgia during the last 4 years were evaluated with 3D FIESTA imaging. All those patients eligible for surgical decompression underwent a standard MVD in the form of a small retromastoid suboccipital craniotomy and Microvascular decompression done using a sheet of Teflon to intervene between the vessel and the Vth nerve. Any arachnoid bands across the nerve were carefully divided. Standard post-operative care given. The results were evaluated and tabulated.

Results: 65% (N=13) of the patients had immediate postoperative relief. 15% (N=3) showed delayed but good pain relief in 3 weeks period. 20% (N=4) 20% pts did not show any pain relief at all post operatively. There were no mortalities in the series and no redo surgeries were performed in the series.

Conclusion: Micro-vascular decompression is safe and effective in producing good pain relief over a long term in patients with Trigeminal neuralgias refractive to medical treatment.



Micro-vascular decompression, Trigeminal neuralgia, Neuro-vascular compression

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R Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS. Etiology and definitive microsurgical treatment of hemifacial spasm: Operative techniques and results in 47 patients. J Neurosurg. 1977;47:321-8.

Civelek E, Cansever T, Imer M, Hepgul K, Barlas O. Trigeminal neuralgia and treatment options. Agri. 2005;17:19-26.

Pamir MN, Peker S. Microvascular decompression for Trigeminal neuralgia:A lo ng term follow-up study. Minim Invas Neurosurg. 2006;49:342-6.

Olson S, Atkinson L, Weidmann M. Microvascular decompression for trigeminal neuralgia: Recurrences and complications. J Clin Neurosci. 2005;12:787-9.

Taha JM, Tew JM Jr. Comparison of surgical treatments for trigeminal neuralgia: Reevaluation

of radiofrequency rhizotomy. Neurosurgery. 1996;38: 865.

Barker FG 2nd , Jannetta PJ, Bissonette DJ, Jho HD. Trigeminal numbness and tic relief after microvascular decompression for typical trigeminal neuralgia. N Engl J Med. 1996;334:1077-83.

Kuncz A, Vφrφs E, Barzó P, Tajti J, Milassin P, Mucsi Z, et al. Comparison of clinical symptoms and magnetic resonance angiographic (MRA) results in patients with trigeminal neuralgia and persistant idiopathic facial pain Medium term outcomeafter microvascular decompression with positive MRA findings. Cephalalgia. 2006;26:266-76.

Merrison AF, Fuller G. Treatment options for trigeminal neuralgia. BMJ. 2003;327:1360-1.

Baechli H, Gratzl O. Microvascular decompression in trigeminal neuralgia with no vascular compression. Eur Surg Res. 2007;39:51-7.

Pamir MN, Zirh TA, Ozer AF, Kele? GE, Baykan N. Microvascular decompression in the surgical management of trigeminal neuralgia. Neurosurg Rev. 1995;18:163-7.

Ashkan K, Marsh H. Microvascular decompression for trigeminal neuralgia in the elderly: A review

of the safety and efficacy. Neurosurgery. 2004;55: 840-50.

Kabatus S, Karasu A, Civelek E, Sabanci AP, Hepgul KT, Teng YD. Microvascular decompression as a surgical management for trigeminal neuralgia; long term follow-up and review of literature. Neurosurg Rev. 2009;32:87-94.