Microvascular decompression for trigeminal neuralgia: Pearls and technique for the classic procedure that stands the test of time

Abstract

Trigeminal neuralgia (TN) is a kind of neuropathic pain that is found to be persistent and classically has
sudden, excruciating pain in the facial area that is similar to electric shock or stabbing-like pain. Microvascular
decompression has consistently remained the predominant procedure for TN every year since 1992 and presently
constitutes over 90% of the surgical interventions carried out for neuropathic facial pain. This article describes
the technical aspects of the surgical planning and the procedure for microvascular decompression, along with
an operative video. In total, 75–80% of patients are known to have complete relief after the procedure, which
makes this classic procedure a must-have for the neurosurgeon in the arsenal of armaments in trigeminal
neuralgia management.