Operative Findings during Microvascular Decompression in Patients with Idiopathic Trigeminal Neuralgia
Keywords:
Idiopathic trigeminal neuralgia, microvascular decompression, Operative findingsAbstract
Objective: To know about operative findings during microvascular decompression for idiopathic trigeminal neuralgia.
Material and Methods: This prospective observational study was carried out on 108 patients who had idiopathic trigeminal neuralgia at Neurosurgery Department of PGMI, Lady Reading Hospital Peshawar from Jan 2010 to dec 2012 with total 2 year duration. All patients who underwent micro vascular decompression for idiopathic trigeminal neuralgia with both gender and having age from 2nd – 8 th decades were included in the study. Patients’ operative findings were noted during MVD and were documented on predesigned Proforma. Data was analyzed by SPSS version 17 and represented in the form of graphs and charts.
Results: 108 patients were operated for trigeminal neuralgia. Males were 64 (59.25%) and females were 44 (40.74%). Age ranged from 18 – 70 years, mean age was 44 ± 5 years. Right side was involved in 75 (70%) cases. In 106 patients (98%), a neurovascular conflict was found, the superior cerebellar artery (SCA) being the most common cause of compression in 86 (80%) patients. Regarding branches mandibular division (V3) was most commonly involved having 64 (59.25%) patients followed by maxillary (V2) 32 (29.62%) and ophthalmic (V1) division 8 (7.40%). After surgery complete pain relief was noted in 97 (90%) patients. Post operatively, nausea, vomiting and dizziness was noted in 18 (16.66%) cases, diplopia in 5 (4.62%), slight deafness in 4 (3.70%) cerebellum infarct 2 (1.85%), CSF leakage in 6 (5.55%), facial palsy in 8 (7.40%), and wound infection in 5 (4.62%) one of which subsequently died.
Conclusion: Vascular compression of trigeminal nerve is most common cause of Idiopathic neuralgia. Superior cerebellar artery is the most common compressing vessel, found during Microvascular decompression.
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