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Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression

  • Clinical Article
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Abstract

Purpose

To summarize our experience and lessons of microvascular decompression surgery for trigeminal neuralgia caused solely by venous compression.

Methods

Fifteen patients with idiopathic trigeminal neuralgia caused by venous compression only underwent microvascular decompression. The entire course of the trigeminal root was explored thoroughly; and coagulating and cutting techniques were preferred in decompressing the culprit veins. Their clinical features, outcomes and operative complications were analyzed.

Results

The compressing veins included the transverse pontine vein in five cases (33.3%), the transverse pontine vein and the vein of middle cerebellar peduncle in one (6.7%), the transverse pontine vein and the vein of cerebellopontine fissure in one (6.7%), the superior petrosal vein in three (20%), the pontotrigeminal vein in one (6.7%), the vein of the cerebellopontine fissure in two (13.3%), and the plexus venosus or venule in two (13.3%). After microvascular decompression, 11 cases (73.3%) had “excellent” or “good” pain relief. Four cases (26.7%) failed the first surgery; and two of them underwent re-operation and got “excellent” pain relief. Postoperative facial numbness appeared in four cases, due to injury to trigeminal nerve when coagulation.

Conclusion

The transverse pontine vein is the most common offending vein. For this type of trigeminal neuralgia, coagulating and cutting techniques are preferred in decompressing the culprit veins. The entire course of the trigeminal root should be explored and decompressed. Following these principles, excellent or good pain relief could be achieved in most cases; and recurrence is rare. However, sometimes injury to the nerve is unavoidable when coagulating the culprit vein.

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Abbreviations

TN:

Trigeminal neuralgia

MVD:

Microvascular decompression

NVC:

Neuro-Vascular Conflict

REZ:

Root Entry Zone

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Acknowledgements

This study was supported by a grant from the National Science Foundation of China (NSFC, No. 30800316), and by the New Hundred Talents Program of Shanghai JiaoTong University School of Medicine (to Xuesheng Zheng).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China

    Wenyao Hong, Xuesheng Zheng, Zhenghai Wu, Xinyuan Li, Xuhui Wang, Yi Li, Jun Zhong & Shiting Li

  2. The Cranial Nerve Disease Center of Shanghai, 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China

    Wenchuan Zhang, Jun Zhong, Xuming Hua & Shiting Li

Authors
  1. Wenyao Hong
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  2. Xuesheng Zheng
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  3. Zhenghai Wu
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  4. Xinyuan Li
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  5. Xuhui Wang
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  6. Yi Li
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  7. Wenchuan Zhang
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  8. Jun Zhong
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  9. Xuming Hua
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  10. Shiting Li
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Corresponding authors

Correspondence to Xuesheng Zheng or Shiting Li.

Additional information

Wenyao Hong and Xuesheng Zheng contributed equally to this study.

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Hong, W., Zheng, X., Wu, Z. et al. Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression. Acta Neurochir 153, 1037–1042 (2011). https://doi.org/10.1007/s00701-011-0957-x

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  • DOI: https://doi.org/10.1007/s00701-011-0957-x

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