title: Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression.
abstract: OBJECTIVE
  To summarize our experience and lessons of microvascular decompression surgery for trigeminal neuralgia caused solely by venous compression.
  
  
  METHODS
  Fifteen patients with idiopathic trigeminal neuralgia caused by venous compression only underwent microvascular decompression. The entire course of the trigeminal root was explored thoroughly; and coagulating and cutting techniques were preferred in decompressing the culprit veins. Their clinical features, outcomes and operative complications were analyzed.
  
  
  RESULTS
  The compressing veins included the transverse pontine vein in five cases (33.3%), the transverse pontine vein and the vein of middle cerebellar peduncle in one (6.7%), the transverse pontine vein and the vein of cerebellopontine fissure in one (6.7%), the superior petrosal vein in three (20%), the pontotrigeminal vein in one (6.7%), the vein of the cerebellopontine fissure in two (13.3%), and the plexus venosus or venule in two (13.3%). After microvascular decompression, 11 cases (73.3%) had "excellent" or "good" pain relief. Four cases (26.7%) failed the first surgery; and two of them underwent re-operation and got "excellent" pain relief. Postoperative facial numbness appeared in four cases, due to injury to trigeminal nerve when coagulation.
  
  
  CONCLUSIONS
  The transverse pontine vein is the most common offending vein. For this type of trigeminal neuralgia, coagulating and cutting techniques are preferred in decompressing the culprit veins. The entire course of the trigeminal root should be explored and decompressed. Following these principles, excellent or good pain relief could be achieved in most cases; and recurrence is rare. However, sometimes injury to the nerve is unavoidable when coagulating the culprit vein.
authors.affiliation: Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China.
authors.forename: Wenyao
authors.initials: W
authors.lastname: Hong
authors.forename: Xuesheng
authors.initials: X
authors.lastname: Zheng
authors.forename: Zhenghai
authors.initials: Z
authors.lastname: Wu
authors.forename: Xinyuan
authors.initials: X
authors.lastname: Li
authors.forename: Xuhui
authors.initials: X
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Wenchuan
authors.initials: W
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhong
authors.forename: Xuming
authors.initials: X
authors.lastname: Hua
authors.forename: Shiting
authors.initials: S
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002550:Cerebral Veins / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D014276:Trigeminal Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*