Microvascular Decompression Technique for Trigeminal Neuralgia Using a Vascular Clip.

Area of Science:

• Neurosurgery
• Vascular Surgery
• Neurology

Background:

• Microvascular decompression (MVD) is a primary treatment for trigeminal neuralgia (TN).
• The Janetta technique, using Teflon felt, is a common MVD approach.
• Alternative MVD techniques aim for long-term symptom relief.

Observation:

• A 72-year-old female presented with V2/V3 trigeminal neuralgia.
• MRI showed superior cerebellar artery (SCA) compression of the trigeminal nerve.
• A retrosigmoid craniotomy revealed SCA loop indentation at the nerve's root entry zone.

Findings:

• The SCA was mobilized after arachnoid dissection.
• A fenestrated aneurysm clip was used to transpose the SCA loop to the tentorium.
• The patient experienced complete resolution of facial pain post-surgery.

Implications:

• Fenestrated clip transposition is a potentially effective and durable MVD technique.
• This method offers an alternative for alleviating vascular compression in trigeminal neuralgia.
• Further studies may validate this approach for long-term trigeminal neuralgia management.