Trigeminal neuralgia: new surgical strategies

Presentation of the results of treatment in trigeminal neuralgia, using percutaneous radiofrequency coagulation in 712 cases, percutaneous microcompression in 206 cases, and microvascular decompression in 22 cases. Based on the results the following management strategy is proposed: pts. 65 years or younger = percutaneous balloon compression or, if neuroradiological evidence of neurovascular compression) is given, microvascular decompression. Pts. elder than 65 years = thermorhizotomy. It may be repeated in case of recurrence. If the initial operation was percutaneous compression, the second one should be microvascular decompression or, depending on age or other clinical circumstances of the patient, thermorhizotomy.