[Microvascular decompression surgery for trigeminal neuralgia: technical review based on surgical anatomy]

To perform secure microvascular decompression for trigeminal neuralgia, it is important to perform each surgical procedure based on detailed anatomical knowledge. As for microsurgical procedure, there are two major approaches; the supracerebellar approach and the trans-horizontal fissure approach. This article reviews the advantages of each surgical approach and describes points to pay attention to, with figures which will help the surgeon to perform this surgery. The importance of real decompression or transposition of the offending vessels is stressed. The significance of preoperative imaging as well as perioperative management including the patients' positioning is also described.