J Neurol Surg B Skull Base 2016; 77 - LFP-12-02
DOI: 10.1055/s-0036-1592615

Clinical Features and Surgical Tactics in Patients with Trigeminal Neuralgia Caused by Venous Compression

Vladimir Poshataev 1, Vadim Shimansky 1, Sergey Tanyashin 1, Vasiliy Karnaukhov 1, Djemil Odamanov 1, Kirill Shevchenko 1
  • 1Skull Base Department, Burdenko Neurosurgery Institute, Moscow, Russia

Background: Neurovascular conflict (NVC) is considered a main cause of trigeminal neuralgia (TN). Arterial branch is observed in the majority of the cases, but in 3–11% of patients, venous compression is the leading cause of TN development. The aim of the study was to define specific traits of clinical features of TN caused by venous compression and to optimize surgical tactics for vascular decompression in this type of TN.

Methods: During 2000–2014 period, 500 patients with TN were operated in Burdenko Neurosurgery Institute (Moscow, Russia). In 47 patients, vein or group of veins were found as offending vessel(s). In majority of the cases dissection and isolation of compressing vein was performed. All the cases were analyzed.

Results: Prevalence of Type 2 TN was found during the study. Different variants of venous compression were described. Surgical principles of managing venous compression are presented.

Conclusion: Venous compression is a rare variant of TN development. Dissection and decompression of offending vein is preferable. Special attention should be paid for complete exploration and dissection of the Vth cranial nerve. Described surgical tactics is helpful in improving the effectiveness of vascular decompression procedures.