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Microvascular Decompression for Trigmeminal Neuralgia (venous)

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

Microvascular decompression for trigeminal neuralgia
classic symptoms of trigeminal neuralgia CISS MRI showing arterial compression of trigeminal nerve near the brainstem
atypical symptoms of facial pain trigeminal neuralgia well-controlled by medication only patients who are at risk for general anesthesia
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MRI with CISS sequence
Asterion marking the junction of the transverse and sigmoid sinuses superior petrosal vein
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
Risks include CSF leak, damage to cranial nerves nearby resulting in diplopia, hearing loss, or facial palsy,
Risks include CSF leak, damage to cranial nerves nearby resulting in diplopia, hearing loss, or facial palsy,
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