Used to relieve pressure on the cranial nerves by moving or isolating blood vessels that are impacting and irritating those nerves, microvascular decompression is an effective treatment for those patients suffering from trigeminal neuralgia (severe facial pain from irritation the trigeminal nerve) as well as hemifacial spasms (a neuromuscular disorder that results in muscles on one side of the face twitching in an involuntary manner due to irritation of the seventh cranial nerve).
Running to each side of the head, the fifth or trigeminal nerve splits into three branches to bring sensation and feeling to different parts of the face. With the condition known as trigeminal neuralgia a force or pressure is disturbing or otherwise irritating the nerve, most likely because it’s coming into close contact with an artery or vein, which is then compressing the nerve as it enters or exits the brain, causing it to react. And when the trigeminal nerve is irritated due to this compression, microvascular decompression can be effective at relieving the resulting pain and discomfort.
After being given general anesthesia and having their head secured to prevent movement during surgery, a surgeon makes an incision behind the ear and moves away the skin to access the skull and dura membrane covering the brain. Moving aside tissue and reaching the affected cranial nerve (in this case the trigeminal or fifth cranial nerve specifically), any blood vessels impacting the nerve are separated and a barrier (a small pad) is placed between the nerve and the blood vessel to prevent any further contact. All tissues, bone and skin are then replaced to their normal position and any incisions are sealed.
Post-surgery the patient is moved to a recovery unit, and is usually discharged within two days. Relief from the pain of trigeminal neuralgia should be immediate, however in rare cases the pain relief is only temporary. Additionally, there are possible complications resulting from the procedure, such as a loss of hearing and numbness of the face.