If you suffer from the severe pain of trigeminal neuralgia, you probably have tried a number of medications and therapies to find relief. If other treatments have failed and you are considering surgery, microvascular decompression may help you. This surgery technique has been performed for decades. Today, our team at the UCLA Neuromodulation for Movement Disorders and Pain Program is the best choice for expert surgical care in Los Angeles.

What is microvascular decompression?

Microvascular decompression is a minimally invasive procedure that involves removing or relocating any blood vessels putting pressure on the trigeminal nerve.

Am I a candidate for microvascular decompression at UCLA?

At the UCLA Neuromodulation for Movement Disorders and Pain Program, we perform microvascular decompression to treat chronic pain caused by trigeminal neuralgia. This pain condition has several possible causes. We only perform microvascular decompression when the pain involves pressure on the trigeminal nerve.

The procedure is best for patients 65 and younger who have no significant medical or surgical risk factors.

What happens during microvascular decompression for trigeminal neuralgia?

Trigeminal neuralgia is often caused by pressure on the trigeminal nerve from a blood vessel, usually the superior cerebellar artery. During this minimally invasive procedure, your neurosurgeon makes an incision behind your ear to reach the trigeminal nerve. Working with tiny instruments through this hole, your surgeon carefully moves any arteries touching the nerve and removes any veins pushing against it. Your surgeon will place a pad between the vessel and nerve to prevent them from touching again.

What to expect after microvascular decompression for trigeminal neuralgia

The incidence of facial numbness after microvascular decompression is much less than with radiofrequency ablation. Pain relief can be long-lived and effective:

• Up to 90 percent of patients experience complete relief
• Pain recurs in 5 to 17 percent

All surgeries have risks. Possible complications after microvascular decompression include:

• Asceptic meningitis, with head and neck stiffness
• Major neurological problems, including deafness and facial nerve dysfunction
• Mild sensory loss
• Cranial nerve palsy, causing double vision, facial weakness, hearing loss
• On very rare occasions, postoperative bleeding and death

Interested in microvascular decompression at UCLA? Get prepared for your first appointment.