[Neurosurgical treatment of trigeminal neuralgia. Direct approach of percutaneous method?]

During the fifteen past years, the treatment of trigeminal neuralgia resistant to medical therapy has benefited from several neurosurgical techniques, either with percutaneous methods (RF-thermorhizotomy, cisternal injection of glycerol, balloon compression of the gasserian ganglion) or direct approach (microsurgical selective section of pars major, microvascular decompression). The respective advantages and disadvantages of these techniques are presented, both from the authors' experience (609 thermocoagulations, 150 direct approaches in the cerebello-pontine angle) and a review of some important series of the literature.