Neurovascular Decompression in Trigeminal Neuralgia. It’s a treatment safe and effective.
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Abstract
Introduction: Trigeminal neuralgia is an intense pain in one half of the face, the main cause is a neurovascular conflict and the first line of treatment is pain medication. However, in refractory cases, different surgical treatments are indicated, being neurovascular decompression surgery, the most effective one. Materials and Methods: We performed a retrospective chart review of 20 patients diagnosed with trigeminal neuralgia and treated surgically by the main author of this paper between 2018 and 2022. Results: Immediate relief of symptoms was obtained in 100% of cases and 90% of them at 18 months follow-up. In the preoperative study, there was three cases of no neurovascular conflict in the resonance, however, in two of them, intraoperative neurovascular conflict was found. Regarding complications, two patients presented a cerebrospinal fluid fistula and there was one case of facial paresis that reverted after 6 months follow-up. Discussion and Conclusion: Relatively low resonance specificity has been described in several published series. If imaging doesn’t demonstrate neurovascular conflict, it could not rule out the surgery indication, and in case of not finding vascular compression intraoperatively, direct neurolysis has also shown high effectiveness in the pain resolution. Neurovascular decompression in trigeminal neuralgia is safe and effective.
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Trigeminal neuralgia, microsurgery, nerve compression
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