Microvascular decompression is often the most-effective type of surgery for those suffering from trigeminal neuralgia. If you are considering this surgery, it can be helpful knowing how it treats your pain, as well as what you should expect to undergo. It can also be good to know any other alternative options, incase microvascular decompression is not ideal for your situation.
What Causes Trigeminal Neuralgia?
Trigeminal neuralgia can be caused by several things. For instance, the trigeminal nerve may be impinged by something, such as a blood vessel, or the nerve may simply be misfiring. Neurologists can use MRI imaging to detect the presence of compression on the trigeminal nerve. When an impingement exists, medicine can typically only mask pain, not address its root cause. Since long-term use of anticonvulsive medications or pain medications can be very detrimental, surgical intervention is often required when medication fails.
Why Microvascular Decompression Is Used
Microvascular decompression for trigeminal neuralgia is effective because it addresses the root cause of the condition and removes whatever is causing the impingement. And, although it is considered major brain surgery and requires an extended recovery, microvascular decompression offers a success rate of about 80-90 percent. That means that for the vast majority of appropriately selected patients who undergo microvascular decompression, pain is significantly improved.
Good Candidates for Microvascular Decompression
Microvascular decompression is not the best choice for every single patient. When medical management is able to relieve your trigeminal neuralgia without significant side effects, surgical intervention will likely not be the first treatment option. If no clear indication of impingement is shown on imaging, other interventions will likely be considered. In addition, if your overall health is poor, you may not be able to safely undergo general anesthesia or the after-effects of brain surgery. However, for patients in good health with imaging indicative of compression, microvascular decompression is often recommended.
Navigating Microvascular Decompression for Trigeminal Neuralgia
When you and your neurosurgeon have determined that microvascular decompression is your best option, you’ll begin the process of preparing for surgery. First, your entire health history must be discussed with both your neurosurgeon and anesthesiologist. Next, you’ll need to make arrangements for transportation after your hospital release and for in-home support following the surgery. Your benefits will also be considered during this time and necessary financial arrangements should be made. Finally, you’ll undergo the actual procedure and will likely begin to experience relief from your facial pain as your post-surgical pain fades.
After the Surgery: What to Expect
While most patients are released from the hospital within a few days of surgery, a very small number may experience side effects. However, the percentage of patients who experience significant complications is small, especially in patients who are otherwise healthy. The most common issues to anticipate after microvascular decompression for trigeminal neuralgia are head pain, nausea and fatigue. Some patients may confuse resulting head pain with continued pain due to trigeminal neuralgia. The use of narcotic pain medication in the hospital and, to a more limited degree, at home after release can ease the majority of this pain. Likewise, medication can greatly reduce the discomfort caused by post-surgical nausea.
General fatigue is a common side effect experienced after the procedure. As such, ensure that you give yourself plenty of time to recover. Rushing too quickly to go back to work or to push your endurance past what is possible can lead to a prolonged recovery. It’s important to remember that microvascular decompression is major brain surgery and that recovery will occur gradually.
Alternatives to Microvascular Decompression
When you are not a good candidate for microvascular decompression, or if you are part of the extremely small subset of patients for whom microvascular decompression does not lead to adequate pain relief, several other options are available for consideration.
Gamma Knife Radiosurgery
You and your neurosurgeon may discuss Gamma Knife Radiosurgery as an alternative to microvascular decompression for trigeminal neuralgia. During this procedure, highly targeted beams of radiation are focused on the portion of your trigeminal nerve believed to be the cause of your pain. This radiation destroys the ability of the trigeminal nerve to broadcast pain signals.
Percutaneous Rhizotomy
During percutaneous rhizotomy, a specialized needle is threaded into the portion of your trigeminal nerve that is responsible for the pain you are feeling. A burst of heat through this needle kills this portion of the nerve, eliminating the pain.
Pain Stimulator Placement
For extreme or complicated instances of trigeminal neuralgia, the placement of a pain stimulator may be required. The stimulator is placed within your head and attached to the base of the trigeminal nerve. Then, varying frequencies are sent along the nerve to disrupt indications of pain and confuse the nerve from sending out pain signals.
Moving On After Trigeminal Neuralgia
Whether microvascular decompression for trigeminal neuralgia is your chosen route of treatment or if you and your neurosurgeon determine another path to follow, overall success rates from single or combined surgical treatments are very high. You no longer have to live in daily pain!
