Acta Neurochirurgica

, Volume 126, Issue 2–4, pp 144–148 | Cite as

Long-term results of microvascular decompression for trigeminal neuralgia with reference to probability of recurrence

  • T. Sun
  • Sh. Saito
  • O. Nakai
  • T. Ando
Clinical Articles

Summary

Sixty-one patients with trigeminal neuralgia who underwent microvascular decompression were analysed. Vascular compression of the trigeminal nerve root was found in all cases. The recurrence rate of pain in this series was 18% with an average follow-up of 80 months (range: 13 to 126 months). Ten patients developed recurrence of their trigeminal neuralgia during follow-up. Fifteen factors, including the clinical and operative findings in the pain-free patients versus the 10 patients with recurrence were analysed. Only the patients with venous compression singly or in combination with arteries were significantly related to recurrence. There was no relationship between recurrence and the duration of symptoms or the degree of compression. Based on vascular compression as the sole cause of TN, the results and interesting findings can not be explained. With reference to the hypothesis that vascular compression is only one of at least two causative factors for the development of trigeminal neuralgia, it is suggested that the intrinsic lesion in trigeminal neuralgia may be responsible for late recurrence.

Keywords

Trigeminal neuralgia microvascular decompression recurrence intrinsic lesion 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bederson JB, Wilson CB (1989) Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 71: 359–367PubMedGoogle Scholar
  2. 2.
    Burchiel KJ, Clarke H, Haglund M (1988) Long-term efficacy of microvascular decompression in trigeminal neuralgia. J Neurosurg 69: 35–38PubMedGoogle Scholar
  3. 3.
    Barba D, Alksne JF (1984) Success of microvascular decompression with and without prior surgical therapy for trigeminal neuralgia. J Neurosurg 60: 104–107PubMedGoogle Scholar
  4. 4.
    Burchiel KJ (1990) Microvascular decompression — letters to the editor. J Neurosurg 72: 671PubMedGoogle Scholar
  5. 5.
    Dahle L, Essen CV, Kourtopoulos H (1989) Microvascular decompression for trigeminal neuralgia. Acta Neurochir (Wien) 99: 109–112Google Scholar
  6. 6.
    Fromm GH (1993) Physiological rationale for the treatment of neuropathic pain. APS Journal 2: 1–7Google Scholar
  7. 7.
    Fromm GH, Chattha AS, Terrence CF, Class JD (1981) Role of inhibition mechanism in trigeminal neuralgia. Neurology 31: 683–687PubMedGoogle Scholar
  8. 8.
    Hardy DG, Rhoton AL Jr (1978) Microsurgical relationship of the superior cerebellar artery and the trigeminal nerve. J Neurosurg 49: 669–678PubMedGoogle Scholar
  9. 9.
    Hamlyn PJ, King TT (1992) Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study. J Neurosurg 76: 948–954PubMedGoogle Scholar
  10. 10.
    Jannetta PJ, Bissonette DJ (1985) Management of the failed patient with trigeminal neuralgia. Clin Neurosurg 32: 334–347PubMedGoogle Scholar
  11. 11.
    Jannetta PJ (1981) Vascular decompression in trigeminal neuralgia. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York, pp 331–340Google Scholar
  12. 12.
    Klun B (1992) Microvascular decompression and partial sensory rhizotomy in the treatment of trigeminal neuralgia: personal experience with 220 patients. Neurosurgery 30: 49–52PubMedGoogle Scholar
  13. 13.
    Kolluri S, Heros RC (1984) Microvascular decompression for trigeminal neuralgia. Surg Neurol 22: 235–240PubMedGoogle Scholar
  14. 14.
    Latchaw JP, Hardy RW, Forsythe SB, Cook AF (1983) Trigeminal neuralgia treated by radiofrequency coagulation. J Neurosurg 59: 479–484PubMedGoogle Scholar
  15. 15.
    MØller AR (1991) The cranial nerve vascular compression syndrome: I. A review of treatment. Acta Neurochir (Wien) 113: 18–23Google Scholar
  16. 16.
    Matsusgima T, Fukui M, Suzuki S (1989) The microsurgical anatomy of the infratentorial lateral and supracerebellar approach to the trigeminal nerve for tic douloureux. Neurosurgery 24: 890–895PubMedGoogle Scholar
  17. 17.
    MØller AR (1991) The cranial nerve vascular compression syndrom: II. A review of pathophysiology. Acta Neurochir (Wien) 113: 24–30Google Scholar
  18. 18.
    Pollack IF, Jannetta PJ, Bissonette DJ (1988) Bilateral trigeminal neuralgia: a 14-year experience with microvascular decompression. J Neurosurg 68: 559–565PubMedGoogle Scholar
  19. 19.
    Suwa H, Hanakita J, Mizuno M, Ohtsuka T (1993) Long-term follow-up of trigeminal neuralgic patients treated by retrogasserian rhizotomy or by microvascular decompression. Neurol Surg 21: 29–36Google Scholar
  20. 20.
    Szapiro J Jr, Sindou M, D.Sc., Szapiro J (1985) Prognostic factors in microvascular decompression for trigeminal neuralgia. Neurosurgery 17: 920–929PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • T. Sun
    • 1
  • Sh. Saito
    • 1
  • O. Nakai
    • 1
  • T. Ando
    • 1
  1. 1.Department of Surgical NeurologyYamagata University School of MedicineYamagataJapan

Personalised recommendations