Microvascular decompression in trigeminal neuralgia - a prospective study of 115 patients

Anne Sofie Schott Andersen, Tone Bruvik Heinskou, Per Rochat, Jacob Bertram Springborg, Navid Noory, Emil Andonov Smilkov, Lars Bendtsen, Stine Maarbjerg*

*Corresponding author for this work


BACKGROUND: Trigeminal neuralgia is a severe facial pain disorder. Microvascular decompression is first choice surgical treatment of patients with classical TN. There exist few prospective studies with an independent evaluation of efficacy and complications after MVD.

OBJECTIVES: We aimed to assess outcome and complications after microvascular decompression from our center.

METHODS: We prospectively recorded clinical characteristics, outcome, and complications from consecutive patients with either classical or idiopathic (only patients with a neurovascular contact) trigeminal neuralgia undergoing microvascular decompression. Neurovascular contact was evaluated by 3.0 Tesla MRI. Patients were assessed before and 3, 6, 12, and 24 months after surgery by independent assessors.

RESULTS: Of 115 included patients, 86% had a clinically significant outcome (i.e., BNI I - BNI IIIb). There was a significant association between an excellent surgical outcome and the male sex (OR 4.9 (CI 1.9-12.8), p = 0.001) and neurovascular contact with morphological changes (OR 2.5 (CI 1.1-6.0), p = 0.036). Significantly more women (12/62 = 19%) than men (2/53 = 4%) had a failed outcome, p = 0.019. The most frequent major complications were permanent hearing impairment (10%), permanent severe hypoesthesia (7%), permanent ataxia (7%), and stroke (6%). Most patients (94%) recommend surgery to others.

CONCLUSION: Microvascular decompression is an effective treatment for classical and idiopathic (only patients with a neurovascular contact) trigeminal neuralgia with a high chance of a long-lasting effect. The chance of an excellent outcome was highest in men and in patients with classical trigeminal neuralgia. Complications are relatively frequent warranting thorough patient evaluation and information preoperatively.


TRIALS: gov registration no. NCT04445766 .

Original languageEnglish
Article number145
JournalThe Journal of Headache and Pain Online
Issue number1
Pages (from-to)1-15
Number of pages15
Publication statusPublished - 19 Nov 2022


  • Female
  • Humans
  • Male
  • Magnetic Resonance Imaging
  • Microvascular Decompression Surgery
  • Prospective Studies
  • Treatment Outcome
  • Trigeminal Neuralgia/diagnostic imaging


Dive into the research topics of 'Microvascular decompression in trigeminal neuralgia - a prospective study of 115 patients'. Together they form a unique fingerprint.

Cite this