Microvascular Decompression for Trigeminal Neuralgia(a Report of 96 Cases)

Objectives To explore the curative effect of microvascular decompression (MVD) on trigeminal neuralgia and the relationship between sensitive areas of the trigeminal nerve and blood vessels in the parapontine region. Method The clinical data of 96 patients with trigeminal neuralgia who underwent MVD in the parapontine region were analyzed retrospectively. Results The effective rate was 98.96% (95/96). The trigeminal neuralgia did not recur in all the patients during following-up from 3 months to 4 years (mean, 2.7 years). Major complications included the loss of hearing in 4 patients, light or moderate disturbance of facial muscles function in 8, appearance of symptoms of mildly injured lower cranial nerves in 1, and cerebellar symptoms in 3, cerebrospinal leak in 1, greater occipital neuralgia in 1 and delayed healing of wounds in 2. No patients were disabled and died. The causative blood vessels were found in 92 patients with trigeminal neuralgia, which was produced by superior cerebellar artery compression in 20 cases (21.74%), anterior inferior cerebellar artery in 13 cases (14.13%), vertebral artery and basilar artery in 11 cases (11.96%), one than more vessels in 7 (7.61%), the artery of the unknown origin in 19 cases (20.65%), petrosal vein in 21 case (22.83%), and arteriovenous malformation in 1 case (1.09%). Conclusions The MVD in the parapontine region is an effective method to treat trigeminal neuralgia. Intraoperative correct identification of the causative blood vessels producing trigeminal neuralgia and the full decompression are the key to ensuring the success of MVD.