What is Microvascular Decompression?

Microvascular decompression is a surgery to treat trigeminal neuralgia. A neurosurgeon relieves pressure (typically from a blood vessel) around the trigeminal nerve (sensory nerve running along your head and face).

During the procedure, the surgeon moves the blood vessel away so it doesn’t compress (press on) the trigeminal nerve. This treatment can potentially cure facial pain in people with trigeminal neuralgia.

Why Choose University of Utah Health?

U of U Health specialists comprehensively treat facial pain. Our multispecialty team includes neurosurgeons, interventional pain specialists, and neurologists. Many of our specialists see a high number of patients with facial nerve pain, increasing our experience and expertise. Our providers are members of national organizations, including the Facial Pain Association. Because of this involvement, our patients have easy access to peer support groups and extra resources.

We offer the full range of treatments for trigeminal neuralgia and have the advanced knowledge needed to treat other types of craniofacial pain. We offer coordinated, comprehensive treatment in one convenient setting.

Candidate Criteria for Microvascular Decompression

We offer surgical treatment when medication alone doesn’t relieve facial pain. Candidates for microvascular decompression include those who:

Microvascular decompression is the most effective surgical treatment for patients with classical trigeminal neuralgia. If you have idiopathic or secondary trigeminal neuralgia (nerve pain that develops because of another condition or no known reason) another treatment such as percutaneous rhizotomy or stereotactic radiosurgery may be more effective for you.

Our neurosurgeons run multiple tests, such as magnetic resonance imaging (MRI), to evaluate the cause of trigeminal neuralgia before choosing a treatment option.

What to Expect During Microvascular Decompression Surgery

In microvascular decompression, we give patients general anesthesia, so they remain asleep during surgery. During the procedure, your neurosurgeon will:

  1. Make an incision behind your ear on the side of the facial pain.
  2. Create a small hole in the skull.
  3. Access the trigeminal nerve using a microscope and tiny tools.
  4. Find the blood vessel that’s compressing the nerve and move it out of the way using special padding or a small sling.

How Long Does Microvascular Decompression Surgery Take?

Microvascular decompression surgery usually lasts around three to four hours.

After Microvascular Decompression Surgery

You will stay in the intensive care unit (ICU) immediately after surgery. Your surgical team will monitor your recovery to ensure you can walk comfortably and tolerate a regular diet before returning home. Most patients will stay in the hospital for two days.

Microvascular Decompression Scar

You’ll have a small scar where your surgeon made the incision. The scar is typically about two inches long and runs behind your hairline. Your neurosurgeon will shave a small section of hair where the incision will be made during surgery. The remaining scar is not noticeable after your hair grows back.

Microvascular Decompression Recovery Period

You’ll continue taking your usual medications for trigeminal neuralgia after you return home. Your provider will instruct you on gradually reducing and stopping taking those medicines over the next several weeks and months.

You can walk and resume most daily activities immediately after returning home. You’ll need to avoid heavy lifting for up to six weeks. Most people resume their typical routine around four to six weeks after surgery.

What Are the Side Effects of Microvascular Decompression?

Common side effects of microvascular decompression may include:

  • nausea,
  • pain, or
  • temporary headache.

Pain After Microvascular Decompression Surgery

You’ll likely have some neck pain or a mild headache for the first few days after surgery. Our team will give you medicine to relieve pain if needed. Continue taking your medications as directed.

Microvascular Decompression Surgery Risks

Complications of microvascular decompression are rare but may include:

  • aseptic meningitis (inflammation in the brain’s lining, causing head and neck stiffness);
  • mild sensory loss;
  • neurological problems, such as facial nerve dysfunction or deafness; or
  • stroke.

Microvascular Decompression Success Rate

Microvascular decompressions surgery successfully reduces trigeminal nerve pain in up to 75 percent of patients for up to five years after surgery. It is the most effective treatment option if you have trigeminal neuralgia due to nerve compression.

Pain may return in a small number of patients. If trigeminal nerve pain comes back, we can offer other treatment options.

Schedule an Evaluation with Our Neurosurgeons

If you would like to find out more about trigeminal neuralgia surgery, it’s best to get a referral from your primary care provider or neurologist. Your referring provider will run tests that help our neurosurgeons understand your symptoms and needs when you come in for your appointment.

Most insurance plans cover trigeminal neuralgia surgery. If you don’t have a referral, you may request an appointment online, or call 801-585-6065.

To refer a patient to our neurosurgery team, fill out our referral form or call 801-585-6087.