Microvascular Decompression (MVD) Tic Douloureux

Microvascular decompression is a microsurgical procedure performed through a small opening in a portion of the skull base known as the retromastoid region, about one inch behind the ear. Using an operating microscope, the surgeon is able to explore the fifth cranial nerve from its point of origin in the brain stem, to the point where it enters the base of the skull.

In many cases, the surgeon will find a branch of the cerebellar artery that is compressing or stretching the fifth cranial nerve, which causes the pulsating pain characteristic of Tic Douloureux. The artery can be repositioned, and a small sponge is placed to cushion the nerve, thus relieving pressure. This procedure will relieve the facial pain in 90% of cases. The advantage of MVD is that facial pain can be relieved while preserving nerve function and normal facial sensation.

Click here to view a movie concerning MVD.

A Patient's Story:

Fred had suffered with classic symptoms of Tic Douloureaux for several years. Although his pain was partially controlled with medication, he could not tolerate the side effects of the medication. After reviewing the treatment options (percutaneous rhizotomy, stereotactic radiosurgery, and MVD), he chose MVD for the possibility of pain relief without the loss of facial sensation. Following surgery, Mr. C. spent one night of observation in the neurosurgical ICU, and was discharged on the second post-operative day. His facial pain resolved immediately after surgery and has not returned. At age 69, Fred is now able to enjoy his retirement.