Microvascular decompression as a surgical management for trigeminal neuralgia: long-term follow-up and review of the literature

Abstract

This retrospective study summarizes our experience based on treating 62 patients with trigeminal neuralgia treated with microvascular decompression. All patients had typical trigeminal neuralgia symptoms, with 24 of them (38%) having failed to benefit from other previous treatment paradigms. We excluded subjects with atypical and/or secondary forms of trigeminal neuralgia. Follow-up duration ranged from 5 months to 10 years 6 months, with recurrence being identified in three patients (4.8%).We found that the superior cerebellar artery is the leading offending vessel in our cases (33.9%; 21 patients). Interestingly, seven patients (11.3%) underwent an early reoperation 12-48 h later after the first operation was deemed ineffective. This subgroup recovered satisfactorily following isolation of the pathogenic vessels. Overall, no mortality was observed in our patients, and the only permanent morbidity outcome was a case of facial nerve palsy (1.6%). We conclude that microvascular decompression and its reapplicaiton for patients who showed no pain relief immediately after the first decompression are safe and effective treatments for trigeminal neuralgia.

Trigeminal Neuralgia Associated with the Specific Bridging Pattern of Transverse Pontine Vein: Diagnostic Value of Three-Dimensional Multifusion Volumetric Imaging

“…Although veins sometimes contribute to the NVC in combination with arteries in TN, venous compression alone should be rare, almost 10% as listed in table 2 [3,4,[6][7][8] . The 3 cases presented in this study implied that the specific bridging pattern of the TPV could frequently associate with TN.…”

“…Venous compression alone as the cause of TN is observed at a relatively lower rate, i.e. 6-18% [3,4,[6][7][8] . Only a few authors have reported some differences of its clinical characteristics and surgical outcomes in comparison with arterial compressions [8][9][10] .…”

Current issues of trigeminal neuralgias of compressive origin. Results of surgical treatment regarding the iatrogenias influence

“…У складних випадках можливе поєднання мікро-хірургічної декомпресії та деструктивних методик із дотриманням патогенетично обґрунтованої послі-довності, про свідчить як досвід авторів, так і дані літератури [2,[31][32][33][34][35].…”

Trigeminal Neuralgia Caused by a Choroid Plexus Papilloma of the Cerebellopontine Angle: Case Report and Review of the Literature

“…Typically, the pain is associated with dislocated blood vessels pressing onto the nerve. 1 Cerebellopontine angle tumours that cause compression or traction of the trigeminal nerve are uncommon, 2 -4 but are a recognized cause of secondary trigeminal neuralgia. In some cases, trigeminal neuralgia may result from other disorders, such as multiple sclerosis or infection.…”