Microvascular Decompression for Trigmeminal Neuralgia (venous)

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
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Author: Walter Jean
Published:
Specialties: Neurosurgery
Schools: Georgetown University Hospital
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Basic Info

Contributors: Daniel R. Felbaum

Microvascular decompression is the most effective surgical procedure for treating trigeminal neuralgia in patients with classic symptoms. The most frequent compressive force is the superior cerebellar artery. Here we demonstrate the procedure in a patient with long-standing, classic symptoms of trigeminal neuralgia, in whom we discovered compression from venous structures.

DOI# http://dx.doi.org/10.17797//henaevqy2g

Advanced

Procedure

Microvascular decompression for trigeminal neuralgia

Indications

classic symptoms of trigeminal neuralgia
CISS MRI showing arterial compression of trigeminal nerve near the brainstem

Contraindications

atypical symptoms of facial pain
trigeminal neuralgia well-controlled by medication only
patients who are at risk for general anesthesia

Instrumentation

Setup

Preoperative Workup

MRI with CISS sequence

Anatomy and Landmarks

Asterion marking the junction of the transverse and sigmoid sinuses
superior petrosal vein

Advantages/Disadvantages

Advantage: highly effective in pain reduction for patients with typical symptoms, long-lasting results
Disadvantage: more risk to central nervous system than less-invasive treatments

Complications/Risks

Risks include CSF leak, damage to cranial nerves nearby resulting in diplopia, hearing loss, or facial palsy,

Disclosure of Conflicts

Risks include CSF leak, damage to cranial nerves nearby resulting in diplopia, hearing loss, or facial palsy,

Acknowledgements

References

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