Suboccipital Craniectomy and Treatment of Trigeminal Neuralgia

  • Ronald Brisman
Part of the Topics in Neurosurgery book series (TINS, volume 3)


Suboccipital craniectomy and the operating microscope provide excellent exposure of the trigeminal nerve and nearby structures. The sensory part of the trigeminal nerve may be deliberately denervated by coagulation and/or section, usually of the caudal one third or one half [1]; an alternative maneuver is microvascular decompression [2]. Many patients with intractable pain from trigeminal neuralgia have had relief of pain following either of the above procedures.


Trigeminal Nerve Trigeminal Neuralgia Hemifacial Spasm Superior Cerebellar Artery Microvascular Decompression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dandy WE: The treatment of trigeminal neuralgia by the cerebellar route. Ann Surg 96:787–793, 1932.PubMedCrossRefGoogle Scholar
  2. 2.
    Jannetta PJ: Microsurgical approach to the trigeminal nerve for tic douloureux. Prog Neurol Surg 7:180–200, 1976.Google Scholar
  3. 3.
    Dandy WE: Concerning the cause of trigeminal neuralgia. Am J Surg 24:447–455, 1934.CrossRefGoogle Scholar
  4. 4.
    Gardner WJ, Miklos MV: Response of trigeminal neuralgia to “decompression” of sensory root. Discussion of cause of trigeminal neuralgia. JAMA 170:1773–1776, 1959.Google Scholar
  5. 5.
    Gardner J: Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19:947–958, 1962.PubMedCrossRefGoogle Scholar
  6. 6.
    Jannetta PJ: Trigeminal neuralgia: Treatment by microvascular decompression. In: Neurosurgery, Wilkins RH, Rengachary SS, eds. McGraw-Hill, New York, 1985, pp 2357–2362.Google Scholar
  7. 7.
    Mount LA: The lateral position for operations in the cerebellopontine angle. J Neurosurg 2:460, 1945.CrossRefGoogle Scholar
  8. 8.
    Kolluri S, Heros RC: Microvascular decompression for trigeminal neuralgia: A five year follow-up study. Surg Neurol 22:235–240, 1984.PubMedCrossRefGoogle Scholar
  9. 9.
    Barba D, Alksne JF: Success of microvascular decompression with and without prior surgical therapy for trigeminal neuralgia. J Neurosurg 60:104–107, 1984.PubMedCrossRefGoogle Scholar
  10. 10.
    Adams CB, Kaye AH, Teddy PJ: The treatment of trigeminal neuralgia by posterior fossa microsurgery. J Neurol Neurosurg Psychiat 45:1020–1026, 1982.PubMedCrossRefGoogle Scholar
  11. 11.
    Loveren H, Tew JM, Keller JT, Nurre MA: A 10-year experience in the treatment of trigeminal neuralgia: Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration. J Neurosurg 57:757–764, 1982.PubMedCrossRefGoogle Scholar
  12. 12.
    Piatt JH Jr, Wilkins RH: Treatment of tic douloureux and hemifacial spasm by posterior fossa exploration: Therapeutic implications of various neurovascular relationships. Neurosurgery 14:462–471, 1984.PubMedCrossRefGoogle Scholar
  13. 13.
    Klun B, Prestor B: Microvascular relations of the trigeminal nerve: An anatomical study. Neurosurgery 19:535–539, 1986.PubMedCrossRefGoogle Scholar
  14. 14.
    Hardy DG, Rhoton AL Jr: Microsurgical relationships of the superior cerebellar artery and the trigeminal nerve. J Neurosurg 49: 669–678, 1978.PubMedCrossRefGoogle Scholar
  15. 15.
    Jannetta PJ: Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26:159–162, 1967.PubMedCrossRefGoogle Scholar
  16. 16.
    Haines SJ, Jannetta PJ, Zorub DS: Microvascular relations of the trigeminal nerve. An anatomical study with clinical correlation. J Neurosurg 52:381–386, 1980.PubMedCrossRefGoogle Scholar
  17. 17.
    Apfelbaum RI: Surgical management of disorders of the lower cranial nerves. In: Operative Neurosurgical Techniques, Vol 2, Schmidek HH, Sweet WH, eds. Grune & Stratton, New York, 1982, pp 1063–1082.Google Scholar
  18. 18.
    Breeze R, Ignelzi RJ: Microvascular decompression for trigeminal neuralgia. Results with special reference to the late recurrence rate. J Neurosurg 57:487–490, 1982.PubMedCrossRefGoogle Scholar
  19. 19.
    Piatt JH Jr, Wilkins RH: Correspondence. Microvascular decompression for tic douloureux. Neurosurgery 15:456, 1984.PubMedCrossRefGoogle Scholar
  20. 20.
    Szapiro J Jr, Sindou M, Szapiro J: Prognostic factors in microvascular decompression for trigeminal neuralgia Neurosurgery 17: 920–929, 1985.PubMedCrossRefGoogle Scholar
  21. 21.
    Moller AR, Jannetta PJ: Monitoring auditory functions during cranial nerve microvascular decompression operations by direct recording from the eighth nerve. J Neurosurg 59: 493–499, 1983.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Ronald Brisman

There are no affiliations available

Personalised recommendations