Top

Acta Neurochirurgica

Published in:

01-06-2012 | How I do it

Surgical technique for trigeminal microvascular decompression

Authors: Giovanni Broggi, Morgan Broggi, Paolo Ferroli, Angelo Franzini

Published in: Acta Neurochirurgica | Issue 6/2012

Abstract

Background

Microvascular decompression (MVD) is a non-ablative technique designed to resolve the neurovascular conflict responsible for typical idiopathic trigeminal neuralgia (TN).

Method

With the patient in a supine position, a small elliptical retrosigmoid craniectomy is used to approach the cerebellopontine angle and the trigeminal nerve. After careful exploration of the trigeminal root entry zone, the offending vessel is identified and moved away. Oxidized regenerated cellulose is used to keep the vessel in its new position far from the nerve.

Conclusion

MVD represents the gold standard first line treatment for TN; its aim is to free the nerve from any contact.

Available only for authorised users

Alvernia JE, Fraser K, Lanzino G (2006) The occipital artery: a microanatomical study. Neurosurgery 58(1):ONS114–122PubMedCrossRef

Barker FG, Jannetta PJ, Bissonnette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334(17):1077–1083PubMedCrossRef

Elias WJ, Burchiel KJ (2002) Trigeminal neuralgia and other neuropathic pain syndromes of the head and face. Curr Pain Headache Rep 6(2):115–124PubMedCrossRef

Ferroli P, Nakaji P, Acerbi F, Albanese E, Broggi G (2011) Indocyanine green (ICG) temporary clipping test to assess collateral circulation before venous sacrifice. World Neurosurg 75(1):122–125PubMedCrossRef

Hitotsumatsu T, Matsushima T, Inoue T (2003) Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossophyaryngeal neuralgia: three surgical approach variations: technical note. Neurosurgery 53(6):1436–1443PubMedCrossRef

Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26(Suppl):159–162PubMed

Jannetta PJ (1976) Microsurgical approach to the trigeminal nerve for tic douloureux. Prog Neurol Surg 7:180–200

Jannetta PJ, McLaughlin MR, Casey KF (2005) Technique of microvascular decompression. Technical note. Neurosurg Focus 18(5):E5PubMed

McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK (1999) Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 90(1):1–8PubMedCrossRef

10.

Reis CV, Deshmukh V, Zabramski JM, Crusius M, Desmukh P, Spetzler RF, Preul MC (2007) Anatomy of the mastoid emissary vein and venous system of the posterior neck region: neurosurgical implications. Neurosurgery 61(5 Suppl 2):193–201PubMedCrossRef

Title: Surgical technique for trigeminal microvascular decompression
Authors: Giovanni Broggi
Morgan Broggi
Paolo Ferroli
Angelo Franzini
Publication date: 01-06-2012
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 6/2012
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-012-1324-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical technique for trigeminal microvascular decompression

Abstract

Background

Method

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2012

Uncovertebral hypertrophy is a significant risk factor for the occurrence of heterotopic ossification after cervical disc replacement: survivorship analysis of Bryan disc for single-level cervical arthroplasty

Factors predicting recurrence of chronic subdural haematoma: the influence of intraoperative irrigation and low-molecular-weight heparin thromboprophylaxis

Emil Theodor Kocher: the first Swiss neurosurgeon

Magnetic resonance fluid dynamics for intracranial aneurysms—comparison with computed fluid dynamics

Methothrexate attenuates early neutrophil infiltration and the associated lipid peroxidation in the injured spinal cord but does not induce neurotoxicity in the uninjured spinal cord in rats

Effect of erythrocytes on brain water content and haem oxygenase-1 expression in rats with traumatic intracerebral haemorrhage