Microvascular Decompression (MVD) Procedures

Trigeminal Neuralgia

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face, such as from brushing your teeth or putting on makeup may trigger a jolt of excruciating pain.
Trigeminal neuralgia
 (TN), also known as tic douloureux, is sometimes described as the most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve, which sends branches to the forehead, cheek and lower jaw. It usually is limited to one side of the face. The pain can be triggered by an action as routine and minor as brushing your teeth, eating or the wind. 

Attacks may begin mild and short, but if left untreated, trigeminal neuralgia can progressively worsen. Most patients report that their pain begins spontaneously and seemingly out of nowhere. 
A high-resolution, thin-slice or three-dimensional MRI can reveal if there is compression caused by a blood vessel. Newer scanning techniques can show if a vessel is pressing on the nerve and may even show the degree of compression.

Blood vessel compressing
Trigeminal nerve
Blood vessel compressing
Trigeminal nerve

Multiple vessels compressing the Trigeminal nerve

In the beginning, it is treated with medicines. If the medicines ineffective or has side effects, surgery (microvascular decompression) needs to be considered. It involves microsurgical exposure of the trigeminal nerve root, identification of a blood vessel that may be compressing the nerve, and gentle movement of the blood vessel away from the point of compression. This surgery is done through a small opening in the skull behind the ear.

Microscopic View

Endoscopic View

Compressing blood vessel Trigeminal nerve

Endoscopic View

Trigeminal nerve decompressed Using Febrillar