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Open Access 01-12-2022 | Stroke | Research

Microvascular decompression in trigeminal neuralgia - a prospective study of 115 patients

Authors: Anne Sofie Schott Andersen, Tone Bruvik Heinskou, Per Rochat, Jacob Bertram Springborg, Navid Noory, Emil Andonov Smilkov, Lars Bendtsen, Stine Maarbjerg

Published in: The Journal of Headache and Pain | Issue 1/2022

Abstract

Background

Trigeminal neuralgia is a severe facial pain disorder. Microvascular decompression is first choice surgical treatment of patients with classical TN. There exist few prospective studies with an independent evaluation of efficacy and complications after MVD.

Objectives

We aimed to assess outcome and complications after microvascular decompression from our center.

Methods

We prospectively recorded clinical characteristics, outcome, and complications from consecutive patients with either classical or idiopathic (only patients with a neurovascular contact) trigeminal neuralgia undergoing microvascular decompression. Neurovascular contact was evaluated by 3.0 Tesla MRI. Patients were assessed before and 3, 6, 12, and 24 months after surgery by independent assessors.

Results

Of 115 included patients, 86% had a clinically significant outcome (i.e., BNI I – BNI IIIb). There was a significant association between an excellent surgical outcome and the male sex (OR 4.9 (CI 1.9–12.8), p = 0.001) and neurovascular contact with morphological changes (OR 2.5 (CI 1.1–6.0), p = 0.036). Significantly more women (12/62 = 19%) than men (2/53 = 4%) had a failed outcome, p = 0.019. The most frequent major complications were permanent hearing impairment (10%), permanent severe hypoesthesia (7%), permanent ataxia (7%), and stroke (6%). Most patients (94%) recommend surgery to others.

Conclusion

Microvascular decompression is an effective treatment for classical and idiopathic (only patients with a neurovascular contact) trigeminal neuralgia with a high chance of a long-lasting effect. The chance of an excellent outcome was highest in men and in patients with classical trigeminal neuralgia. Complications are relatively frequent warranting thorough patient evaluation and information preoperatively.

Trial registration

Clinical.trials.gov registration no. NCT04445766.

Available only for authorised users

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Title: Microvascular decompression in trigeminal neuralgia - a prospective study of 115 patients
Authors: Anne Sofie Schott Andersen
Tone Bruvik Heinskou
Per Rochat
Jacob Bertram Springborg
Navid Noory
Emil Andonov Smilkov
Lars Bendtsen
Stine Maarbjerg
Publication date: 01-12-2022
Publisher: Springer Milan
Keywords: Stroke
Trigeminal Neuralgia
Published in: The Journal of Headache and Pain / Issue 1/2022
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-022-01520-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Microvascular decompression in trigeminal neuralgia - a prospective study of 115 patients

Abstract

Background

Objectives

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusion

Trial registration

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