Microvascular Decompression Brain Surgery
Candidates for a Microvascular Decompression
Patients who have been diagnosed with hemifacial spasm, glossopharyngeal neuralgia or trigeminal neuralgia all are candidates for Microvascular Decompression.
Typically, this procedure is recommended for people who have trigeminal neuralgia that is not responding to medication. Candidates for this procedure also prefer to minimize the potential for facial numbness that sometimes is associated with alternative treatments such as a glycerol injections or percutaneous stereotactic radiofrequency rhizotomy.
People who are experiencing facial pain that is confined to the ophthalmic division or in all three of the trigeminal divisions also may be good candidates for Microvascular Decompression, as are individuals who are suffering from the recurrence of facial pain in the aftermath of a radiosurgery or percutaneous procedure.
Not everyone is a good candidate for Microvascular Decompression. Individuals generally in poor health or with other medical conditions may not be eligible for this surgery. Research demonstrates that Microvascular Decompression is not effective at treating facial pain due to multiple sclerosis.
There is a low risk of hearing loss associated with this procedure. Patients who have hearing loss in one ear may not be good candidates.
What is Microvascular Decompression?
Microvascular decompression (MVD) is a surgical procedure that is used to treat trigeminal neuralgia and similar conditions that involve intense pain, facial spasms and muscle twitching. This surgery is especially helpful when medications have not brought relief. MVD surgery helps relieve nerve compression that is caused by a vein or artery, which alleviates pain and other symptoms.
First, the skull is opened in a procedure called a craniotomy. This exposes the nerve located at the brainstem's base. A minuscule sponge is inserted between the compressed nerve and the compressing vein or artery. The sponge effectively isolates the nerve from the pressure and pulsating effect of the blood vessel.
People with trigeminal neuralgia are often good candidates for this surgery. This condition involves compression of the fifth cranial nerve. The resulting pain may be severe, and it usually is felt in the teeth, jaw, cheek or forehead. Patients may experience a significant reduction in their symptoms when the sponge is inserted into the compression.
Results of A Microvascular Decompression Procedure
So, what is life after MVD surgery like? This procedure is extremely successful at treating the symptoms of trigeminal neuralgia. The microvascular decompression success rate is pretty high. In clinical studies, the procedure demonstrated a good success rate for approximately 83 percent of patients. The risk of numbness was low, at approximately nine percent over 35 months. Infection occurred in just over 1.9 percent of patients. In longer-term studies, the success rate was even higher. In one study, 96 percent of patients achieved long-term pain relief after surgery. These studies demonstrate that Microvascular Decompression of the trigeminal nerve can help reduce symptoms significantly and the risks are relatively low.
Doctors and patients tend to opt for Microvascular Decompression more frequently than a percutaneous stereotactic rhizotomy because of the relative lack of risk for suffering facial numbness.
What are the risks of Microvascular Decompression?
All surgery involves risks. It’s important for patients to understand the risks of Microvascular Decompression. The Microvascular Decompression risks include:
A reaction to anesthesia
Blood clots
Infection
Bleeding
Complications that sometimes are associated with any type of craniotomy surgery include cerebrospinal fluid leaks, brain swelling, venous sinus occlusion, seizures and stroke.
The most common complication related to Microvascular Decompression is nerve damage, with patients being at risk of developing an unsteady gait, difficulty swallowing, hoarseness, paralysis or numbness of the face, double vision and hearing loss.