Intraoperative decisions and surgical efficacies of trigeminal neuralgia responsible vessels

Objective To explore the types of primary trigeminal neuralgia (TN) responsible vessels and curative efficacies of microscopic vascular decompression (MVD). Methods A total of 162 primary TN patients underwent MVD from August 2004 to the present at our hospital.Their clinical data were collected and analyzed.There were 69 males and 93 females with an age range of 22-88 years. Results The most common responsible vessels were superior cerebellar artery (n=65, 40.12%), anterioinferior cerebellar artery (n=45, 27.78%), multiple vessels (n=26, 16.05%), posterioinferior cerebellar artery (n=16, 9.88%), veins (n=6, 3.70%) and vertebral artery (n=4, 2.47%).And the pressure points were at the root of trigeminal nerve (n=139,85.80%), distal part (n=16, 9.88%) and root and distal part (n=7, 4.32%).Postoperatively pain disappeared in all patients (including one case on second surgery).Postoperative follow-ups were conducted for 132 cases.Two cases recurred over 8 years and the recurrence rate was 1.52%. Conclusion MVD is preferred method for primary T N non-responsive to pharmacotherapy.Identification and treatment of responsible vessels remain a key.Venous and distal pressure points should be taken care. Key words: Trigeminal neuralgia; Responsible vessels; Microvascular decompression