[Microvascular decompression in patients with trigeminal neuralgia]

ABSTRACT

Trigeminal neuralgia is a common disorder with well established diagnostic characteristics. Remission of symptoms with carbamazepine seems diagnostic, however, cases who failed to respond might advise surgery. In the present study, we investigate postoperative complications and outcomes in a group of Iranian patients referring with trigeminal neuralgia during a 10-year period. It was a retrospective study. We reviewed medical files of patients referring with trigeminal neuralgia and underwent microvascular decompression during a 10-year period [1995-2004]. Totally, 35 patients with the mean age of 55 years and male to female ratio of 1.33 underwent microvascular decompression. A combination of maxillary and mandibular branches of trigeminal nerve was the most commonly involved root, reported in almost half of the patients. Superior cerebellar artery was, by far, the most frequent compressor of the nerve. Immediate response to surgery was reported in 83%. Postoperative complications were observed in 8 patients, 4 due to medications while the other 4 were believed to be neurologic in origin. Unfortunately, 2 patients died. Patients were followed for 1-46 months [mean 14 months], during which 4 returned with symptoms recurrence and received medical therapy. Microvascular decompression is the standard surgical approach for trigeminal neuralgia since it is associated with symptoms relief, excellent postoperative outcomes, minor complications and low recurrence rate