Skip to main content
Log in

The cranial nerve vascular compression syndrome: I. A review of treatment

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The author reviews current literature on microvascular decompression (MVD) for treatment of hemifacial spasm (HFS) and trigeminal neuralgia (TN), which shows that MVD is an effective treatment for these disorders. Although there are treatments for TN other than MVD that demonstrate a high rate of success, MVD is the only effective long-term treatment for HFS. MVD is also an effective treatment for glossopharyngeal neuralgia (GPN), and recently MVD has been shown to be an effective treatment for particular types of vertigo (disabling positional vertigo, DPV) and certain types of tinnitus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adams CBT, Kaye AH, Teddy PJ (1982) The treatment of trigeminal neuralgia by posterior fossa microsurgery. J Neurol Neurosurg Psychiatry 45: 1020–1026

    PubMed  Google Scholar 

  2. Aoki N, Nagao T (1986) Resolution of hemifacial spasm after posterior fossa exploration without vascular decompression. Neurosurgery 18: 478–479

    PubMed  Google Scholar 

  3. Apfelbaum RI (1984) Surgery for tic douloureux. Clin Neurosurg 31: 351–368

    Google Scholar 

  4. Apfelbaum RI (1988) Surgical management of disorders of the lower cranial nerves. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques, indications, methods, and results, Vol. 2, Chap 69. Grune and Stratton, Orlando, pp 1063–1082

    Google Scholar 

  5. Barba D., Alksne FJ (1984) Success of microvascular decompression with and without prior surgical therapy for trigeminal neuralgia. J Neurosurg 60: 104–107

    PubMed  Google Scholar 

  6. Bederson JB, Wilson CB (1989) Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 71: 359–367

    PubMed  Google Scholar 

  7. Bertrand RA, Molina P, Hardy J (1977) Vestibular syndrome and vascular anomaly in the cerebello-pontine angle. Acta Otolaryngol (Stockh) 83: 187–194

    Google Scholar 

  8. Breeze R, Ignelzi RJ (1982) Microvascular decompression for trigeminal neuralgia. Results with special reference to the late recurrence rate. J Neurosurg 57: 487–490

    PubMed  Google Scholar 

  9. Burchiel KJ, Clarke H, Haglund M, Loeser JJ (1988) Long-term efficacy of microvascular decompression in trigeminal neuralgia. J Neurosurg 69: 35–38

    PubMed  Google Scholar 

  10. Dahle L, von Essen H, Kourtopoulos P, Ridderheim PA, Vavruch L (1989) Microvascular decompression for trigeminal neuralgia. Acta Neurochir (Wien) 99: 109–112

    Google Scholar 

  11. Dandy WE (1934) Concerning the cause of trigeminal neuralgia. Am J Surg 24: 447–455

    Google Scholar 

  12. Elmquist D, Toremalm NG, Elner A, Mercke U (1982) Hemifacial spasm and electrophysiological findings and the therapeutic effect of facial nerve block (Special Lambert Symposium). Muscle Nerve 5: S 89-S 94

    Google Scholar 

  13. Ferguson GG, Brett DC, Peerless SJ, Barr HWK, Girvin JP (1981) Trigeminal neuralgia: A comparison of the results of percutaneous rhizotomy and microvascular decompression. Can J Neurol Sci 8: 207–214

    PubMed  Google Scholar 

  14. Fisch U (1986) Extracranial surgery for facial hyperkinesis. In: May M (eds) The facial nerve. Thieme, New York, pp 509–523

    Google Scholar 

  15. Freckmann N, Hagenah R, Hermann HD, Muller D (1981) Treatment of neurogenic torticollis by microvascular lysis of accessory nerve roots — Indication, technique, and results. Acta Neurochir (Wien) 59: 167–175

    Google Scholar 

  16. Fromm GH (1991) Pathophysiology of trigeminal neuralgia. In: Fromm GH, Sessle BJ (eds) Trigeminal neuralgia. Butterworth Heineman, Boston

    Google Scholar 

  17. Gardner WJ, Sava GA (1962) Hemifacial spasm — a reversible pathophysiologic state. J Neurosurg 19: 240–247

    Google Scholar 

  18. Haines SJ, Torres F (1991) Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm. J Neurosurg 74: 254–257

    PubMed  Google Scholar 

  19. Iwakuma T, Matsumoto A, Nakamura N (1982) Hemifacial spasm, Comparison of three different operative procedures in 110 patients. J Neurosurg 57: 753–756

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  21. Jannetta PJ (1970) Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2: 217–220

    Google Scholar 

  22. Jannetta PJ (1975) Neurovascular cross-compression of patients with hyperactive dysfunction symptoms of the eighth cranial nerve. Surg Forum 26: 467–469

    PubMed  Google Scholar 

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

    Google Scholar 

  24. Jannetta PJ (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definite microsurgical treatment and results in 117 patients. Neurochirurgia (Stuttg) 20: 145–154

    Google Scholar 

  25. Jannetta PJ (1980) Neurovascular compression in cranial nerve and systemic disease. Ann Surg 192: 518–525

    PubMed  Google Scholar 

  26. Jannetta PJ, (1981 a) Hemifacial spasm. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York, pp 484–493

    Google Scholar 

  27. Jannetta PJ (1981 b) Vascular decompression in trigeminal neuralgia. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York pp 331–340

    Google Scholar 

  28. Jannetta PJ (1984) Hemifacial spasm caused by a venule: Case report. Neurosurgery 14: 89–92

    PubMed  Google Scholar 

  29. Jannetta PJ (1990) Microvascular decompression of the trigeminal nerve root entry zone. In: Rovit RL, Murali R, Jannetta PJ (eds) Trigeminal neuralgia. Williams & Wilkins, Baltimore, pp 201–222

    Google Scholar 

  30. Jannetta PJ, Abbasy M, Maroon JC, Morales-Ramos F, Albin MS (1977) Etiology and definite microsurgical treatment of hemifacial spasm: Operative technique and results in 47 patients. J Neurosurg 47: 321–328

    PubMed  Google Scholar 

  31. Jannetta PJ, Møller MB, Møller AR (1984) Disabling positional vertigo (DPV). N Engl J Med 310: 1700–1705

    PubMed  Google Scholar 

  32. Kaye AH, Adams CBT (1981) Hemifacial spasm: A long term follow-up of patients treated by posterior fossa surgery and facial nerve wrapping. J Neurol Neurosurg Psychiatry 44: 1100–1103

    PubMed  Google Scholar 

  33. Kolluri S, Heros R (1984) Microvascular decompression for trigeminal neuralgia. Surg Neurol 22: 235–240

    PubMed  Google Scholar 

  34. Kondo A, Ishikawa J, Yamasaki T, Konishi T (1980) Microvascular decompression of cranial nerves, particularly of the seventh cranial nerve. Neurol Med Chir (Tokyo) 20: 739–751

    Google Scholar 

  35. Kraft SP, Lang AE (1988) Cranial dystonia, blepharospasm and hemifacial spasm: Clinical features and treatment, including the use of botulinum toxin. Can Med Assoc J 139: 837–846

    Google Scholar 

  36. Lang J (1982) Über Bau, Länge and Gefässbeziehungen der „zentralen“ and „peripheren“ Strecken der intrazisternalen Hirnnerven. Zentralbl Neurochir 43: 217–256

    PubMed  Google Scholar 

  37. Lang J (1983) Clinical anatomy of the head, neurocranium, orbit, and cranio-cervical region. Springer, New York

    Google Scholar 

  38. Lang J (1985) Anatomy of the brainstem and the lower cranial nerves, vessels and surrounding structures. Am J Otolaryngol S 1: 1–19

    Google Scholar 

  39. Liu KN, Wu JM, Fairholm D (1981) Hemifacial spasm: Treatment by posterior fossa surgery. J Formosan Med Assoc (Taipei) 80: 1235–1239

    Google Scholar 

  40. Loeser JD, Chen J (1983) Hemifacial spasm: Treatment by microsurgical facial nerve decompression. Neurosurgery 13: 141–146

    PubMed  Google Scholar 

  41. Lunsford LD, Apfelbaum RI (1985) Choice of surgical therapeutic modalities for treatment of trigeminal neuralgia: Microvascular decompression, percutaneous retrogasserian thermal, or glycerol rhizotomy. Clin Neurosurg 32: 319–333

    PubMed  Google Scholar 

  42. Møller AR, Jannetta PJ (1985) Microvascular decompression in hemifacial spasm: Intraoperative electrophysiological observations. Neurosurgery 16: 612–618

    PubMed  Google Scholar 

  43. Møller AR, Jannetta PJ (1987) Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm. J Neurosurg 66: 681–685

    PubMed  Google Scholar 

  44. Møller MB (1990 a) Results of microvascular decompression (MVD) of the eighth nerve as treatment for disabling positional vertigo (DPV). Ann Otol Rhinol Laryngol 99: 724–729

    PubMed  Google Scholar 

  45. Møller MB (1990 b) Disabling positional vertigo. In: Myers EN, Bluestone CD, Brackmann DE, Krause CJ (eds) Advances in otolaryngology — head and neck surgery, Vol. 4. Mosby Year Book, Inc, Chicago, pp 81–106

    Google Scholar 

  46. Møller MB, Møller AR (1990) Vascular compression syndrome of the eighth nerve: Clinical correlations and surgical findings. In: Arenberg IK, Smith DM (eds) Neurologic clinics: diagnostic neurotology and otoneurology. WB Saunders Publishing Co, Philadelphia, pp 421–439

    Google Scholar 

  47. Møller MB, Møller AR, Jannetta PJ, Sekhar LN (1986) Diagnosis and surgical treatment of disabling positional vertigo. J Neurosurg 64: 21–28

    PubMed  Google Scholar 

  48. Neagoy DR, Dohn DF (1974) Hemifacial spasm secondary to vascular compression of the facial nerve. Cleve Clin Quart 41: 205–214

    Google Scholar 

  49. Panagopoulos K, Chakraborty M, Deopujari CE, Sengupta RP (1987) Neurovascular decompression for cranial rhizopathies. Br J Neurosurg 1: 235–241

    PubMed  Google Scholar 

  50. Pollack IF, Jannetta PJ, Bissonetta DJ (1988) Bilateral trigeminal neuralgia: A 14-year experience with microvascular decompression. J Neurosurg 68: 559–565

    PubMed  Google Scholar 

  51. Rushworth RG, Smith SF (1982) Trigeminal neuralgia and hemifacial spasm. Med J Australia 1: 424–426

    PubMed  Google Scholar 

  52. Sindou M, Amrani F, Mertens P (1990) Decompression vasculaire microchirurgicale pour neuralgie du trijumeau. Neurochirurgie 36: 16–26

    PubMed  Google Scholar 

  53. Sunderland S (1981) Cranial nerve injury. Structural and pathophysiological considerations and a classification of nerve injury. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York, pp 16–23

    Google Scholar 

  54. Szapiro J, Sindou M, Szapiro J (1985) Prognostic factors in microvascular decompression for trigeminal neuralgia. Neurosurgery 17: 920–929

    PubMed  Google Scholar 

  55. Taarnhoj P (1982) Decompression of the posterior trigeminal root in trigeminal neuralgia. J Neurosurg 57: 14–17

    PubMed  Google Scholar 

  56. Tarlow IM (1937) Structure of a nerve root. Arch Neurol Psychiatry 37: 556–583

    Google Scholar 

  57. Van Loveren H, Tew JM, Keller JT, Nurre MA (1982) A 10-year experience in treatment of trigeminal neuralgia. Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration. J Neurosurg 57: 757–764

    PubMed  Google Scholar 

  58. Wilkins RH (1981) Hemifacial spasm: Treatment by microvascular decompression of the facial nerve at the pons. South Med J 74: 1471–1474

    PubMed  Google Scholar 

  59. Wilson CB, Yorke C, Prioleau G (1980) Microsurgical vascular decompression for tirgeminal neuralgia and hemifacial spasm. West J Med 132: 481–487

    PubMed  Google Scholar 

  60. Yeh HS, Tew JM, Ramirez RM (1981) Microsurgical treatment of intractable hemifacial spasm. Neurosurgery 9: 383–386

    PubMed  Google Scholar 

  61. Zorman G, Wilson CB (1984) Outcome following microvascular decompression of partial sensory rhizotomy in 125 cases of trigeminal neuralgia. Neurology 34: 1362–1365

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Møller, A.R. The cranial nerve vascular compression syndrome: I. A review of treatment. Acta neurochir 113, 18–23 (1991). https://doi.org/10.1007/BF01402109

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01402109

Keywords

Navigation