Microvascular Decompression for Trigeminal Neuralgia

Information about Surgery for Trigeminal Neuralgia

Microvascular decompression (MVD) eliminates (or greatly reduces) the sharp bursts of pain in the facial nerves caused by trigeminal neuralgia.  Surgery generally aims to move the compressive blood vessel away from the trigeminal nerve (microvascular decompression) and is successful in up to 90% of patients.  The procedure is performed under general anaesthesia and requires a short hospital stay.  

For more information about microvascular decompression (MVD) watch the video below.  

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Risks of Microvascular Decompression (MVD)

Microvascular decompression improves or cures symptoms of face pain in up to 90% of patients with trigeminal neuralgia.  Like any surgical procedure there risks involved, however, the chance of having a serious complication is small.  

Risks of Anaesthesia

Risks of anaesthesia will be discussed with you by your anaesthetist prior to surgery.  It is important that you inform us of your correct age and any past medical problems, as this can influence the risk of anaesthesia.  Risks include:

• Heart problems, such as heart attack (AMI) or arrhythmia  
• Lung problems,  such as infection (pneumonia) or blood clots
• Urinary tract infection
• Deep Venous Thrombosis (DVT)
• Eye or visual problems
• Pressure wounds
• Stroke
• Small risk of significant life-threatening event

General Risks of Craniotomy

Although microvascular decompression generally safe, there are some risks whenever performing a craniotomy.  These include:

• Infection 1-2%
• Seizures which can require taking medication.  Rarely this can lead to epilepsy requiring longterm medication. 
• Bleeding.  This can occur at the time of surgery and may necessitate a blood transfusion.  It can also occur at some time after surgery.   The bleeding may be present in the brain or adjacent to it.  Sometimes another operation is required to drain the bloodclot and stop the bleeding.  
• Stroke
• Brain fluid leak (CSF leak)
• Small risk of significant neurological injury causing paralysis, coma or death.  

Specific Risks of Microvascular Decompression

The specific risks will be discussed in detail prior to your surgery but may include:

• Facial weakness
• Numbness of the face
• Damage nerves in the brain (cranial nerves) resulting in facial numbness, weakness of the face, loss of vision or double vision, difficulty swallowing or coughing, tongue paralysis, respiratory and cardiac problems.  
• Deafness in the ear on same side as the facial pain
• Weakness or numbness in the limbs 
• Balance or gait problems
• Paralysis (stroke like symptoms)
• Brainstem injury
• Intracranial arterial injury
• Visual problems
• CSF leak and collection under the wound
• Persistant symptoms
• Recurrence of symptoms