Trigeminal neuralgia treatment with microvascular decompression

Trigeminal neuralgia can be effectively treated with microvascular decompression, considered the "gold standard. " This neurosurgical procedure aims to reduce the symptoms caused by nerve compression from an artery or vein. It is recommended for patients who have not responded well to medication or have experienced a relapse of symptoms after radiosurgery. The surgery usually takes 2 to 3 hours and is performed with general anesthesia. The patient is positioned on his side with his head immobilized. A hair preservation technique is utilized, where only a tiny section less than one centimeter in width along the planned skin incision is shaved. A neuronavigation system is used during surgery to ensure precise instrument placement. Neuronavigation helps prevent nerve damage, preserving its functions throughout the procedure. Behind the ear, the surgeon performs an incision measuring 5-6 cm. Then, using a drill, he makes a hole in the occipital bone with a diameter of up to 2 cm. To access the nerve, the doctor will carefully move the surrounding structures. Next, the doctor exposes the trigeminal nerve and identifies the affected vessel causing compression. Next, a Teflon gasket is installed between the nerve and the vessel. After installing the pad, the brain structures are returned to their place, and the wound is closed. Finally, a soft, sticky bandage is applied to the incision. The stitches are removed after a few days.