Microvascular Decompression in Patients Aged 30 Years or Younger

Area of Science:

• Neurosurgery
• Neurology
• Vascular Surgery

Background:

• Hemifacial spasm (HFS) and trigeminal neuralgia (TN) typically affect older individuals.
• Early-onset cases of HFS and TN are less common, and their underlying causes require further investigation.

Purpose of the Study:

• To determine the etiology of hemifacial spasm and trigeminal neuralgia in patients 30 years or younger.
• To evaluate the effectiveness of microvascular decompression (MVD) for these conditions in a young patient cohort.

Main Methods:

• Retrospective analysis of 7 patients (6 HFS, 1 TN) aged 30 or younger who underwent MVD between 1996 and 2012.
• Patient data included medical history, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), surgical findings, and follow-up assessments.

Main Results:

• Vascular variations, including duplicate arteries and aberrant courses, were identified in 5 of the 6 HFS patients.
• Post-MVD, 5 HFS patients became asymptomatic, and 1 experienced mild residual symptoms.
• The TN patient showed significant pain amelioration after MVD, requiring no medication despite occasional residual pain.

Conclusions:

• Vascular variations may contribute to the etiology of neurovascular compression in early-onset HFS and TN.
• Microvascular decompression is a viable and effective treatment for neurovascular compression symptoms in young patients.