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Updated: Jul 18, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Microvascular decompression vs. gamma knife radiosurgery for typical trigeminal neuralgia: preliminary findings
1Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA. rb36@columbia.edu
Background:
Patients with typical trigeminal neuralgia were treated by one neurosurgeon with either microvascular decompression (MVD) or Gamma Knife radiosurgery (GKRS) and were prospectively evaluated with a uniform protocol.
Method:
GKRS was done with 75 Gy maximum to the cisternal trigeminal nerve near the pons. MVD was done without cauterizing or cutting the trigeminal nerve.
Results:
Twenty-four patients were treated with MVD and 61 with GKRS. Complete pain relief (no pain no medicines) occurred at 12 and 18 months in 68 and 68% of patients treated with MVD and 58 and 24% with GKRS (p = 0.089), and >or=90% pain relief (with or without medicine) at 12 and 18 months in 90 and 78% with MVD and 75 and 48% with GKRS (p = 0.171). There were no permanent complications.
Conclusion:
Although many trigeminal neuralgia patients treated with either MVD or GKRS have pain relief, MVD is more likely than GKRS to result in complete pain relief.
