Microvascular decompression for trigeminal neuralgia in patients over 70 years of age

Abstract

Treatment options for patients with trigeminal neuralgia (TN) include pharmacotherapy, peripheral and gasserian ganglion-level procedures, microvascular decompression (MVD), and stereotactic radiosurgery. It is generally agreed that MVD provides the longest duration of pain relief while preserving facial sensation.1,2⇓ In experienced hands, MVD can be performed with low morbidity and mortality.1 Most authors would offer MVD to young patients with TN. However, many consider MVD inappropriate in the treatment of elderly patients because of suspected high morbidity and mortality rates in this age group. Few authors advocate MVD for the treatment of elderly patients with TN.3 All patients with TN referred to our unit in the 1990s had magnetic resonance tomoangiography (MRTA) to show the relationship of the affected trigeminal nerve root to adjacent blood vessels.4 Subject to satisfactory anesthetic assessment, MVD is offered as …