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Acta Neurochirurgica

, Volume 154, Issue 6, pp 1089–1095 | Cite as

Surgical technique for trigeminal microvascular decompression

  • Giovanni Broggi
  • Morgan BroggiEmail author
  • Paolo Ferroli
  • Angelo Franzini
How I do it

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.

Keywords

Microvascular decompression Trigeminal neuralgia Surgical technique Retrosigmoid approach 

Abbreviations

MVD

Microvascular decompression

TN

Typical idiopathic trigeminal neuralgia

CSF

Cerebrospinal fluid

TREZ

Trigeminal root entry zone

GA

General anesthesia

OA

Occipital artery

MEV

Mastoid emissary vein

TS

Transverse sinus

SS

Sigmoid sinus

CN

Cranial nerve

CPA

Cerebellopontine angle

SPV

Superior petrosal vein

MR

Magnetic resonance

Notes

Conflicts of interest

None.

Supplementary material

ESM 1

(MPG 143,818 kb)

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Giovanni Broggi
    • 1
  • Morgan Broggi
    • 1
    Email author
  • Paolo Ferroli
    • 1
  • Angelo Franzini
    • 1
  1. 1.Department of NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly

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