Does trigeminal neuralgia require craniotomy?

Written by Li Pei
Neurosurgery
Updated on November 22, 2024
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If the severity of trigeminal neuralgia is mild, oral medication can be chosen as the first treatment option. If the effects of the medication are not significant, radiofrequency treatment for the trigeminal nerve or balloon compression therapy can be considered, although these two methods do have a certain recurrence rate.

If the effects of medications and treatments like radiofrequency are not significant, microvascular decompression surgery for the trigeminal nerve can be considered. This surgery requires general anesthesia and craniotomy, and under a microscope, the trigeminal nerve and the blood vessels compressing it are separated using a special material, which can relieve the pain of trigeminal neuralgia.

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Written by Chen Yu Fei
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Causes of Trigeminal Neuralgia

At present, there is no consensus on the specific causes of trigeminal neuralgia. Most scholars believe that the main cause of trigeminal neuralgia is still due to the presence of a local responsible blood vessel around the trigeminal nerve, which compresses the trigeminal nerve, leading to abnormal discharges of the trigeminal nerve. This results in sudden attacks and sudden stops of severe, knife-like or burning pain, also known as trigeminal neuralgia. In terms of treatment, it mainly involves active drug therapy and some physical therapies, such as massage, manipulation, physiotherapy, and acupuncture. Most patients who experience poor results from conservative treatments can opt for microvascular decompression surgery, which often achieves good therapeutic outcomes.

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Written by Jiang Fang Shuai
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Is trigeminal neuralgia severe?

Trigeminal neuralgia is one of the most common, stubborn, and excruciatingly painful diseases, known by patients as the "world's most severe pain." The intensity of the pain during an episode can surpass even that of childbirth. When the pain is severe, patients dare not speak, eat, or sleep, causing immense suffering in their lives. In extreme cases, the unbearable pain leads to suicidal thoughts. Therefore, trigeminal neuralgia is also referred to as the "non-lethal cancer," a serious neurological disorder.

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Written by Gao Yi Shen
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Trigeminal neuralgia should register for which department?

The department for registering trigeminal neuralgia depends on the distribution of departments in the local hospital. Most commonly, registration is done in the department of functional neurosurgery. However, different hospitals may have different levels of specialization and may employ varying treatment methods which require different departments. For instance, initially, one can register at the department of neurosurgery for oral medication adjustment, usually with carbamazepine. If there is no significant improvement later on, one may register with the department of pain management or anesthesiology for nerve block treatment. Due to the detailed specialization in some hospitals, it might also be necessary to consult other departments. If there is still no effective outcome, it is necessary to register at the department of neurosurgery for surgical treatment to fundamentally address the disease.

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Written by Guo Zhi Fei
Neurosurgery
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Radical treatment method for trigeminal neuralgia

The fundamental cause of trigeminal neuralgia lies in the compression of the trigeminal nerve root by aberrant blood vessels around the area where it exits the brain stem. This compression leads to demyelination of the trigeminal nerve and causes a short circuit in the trigeminal nerve conduction pathway, resulting in trigeminal neuralgia. Currently, the only definitive cure for trigeminal neuralgia is microvascular decompression surgery. This surgery addresses the cause of trigeminal neuralgia by opening the skull, locating the trigeminal nerve and the compressing vessel, and placing a cushion between the nerve and the vessel to achieve a cure. This type of surgery is characterized by minimal trauma, preservation of nerve function, rapid recovery, and low complication rates, making it the best treatment for trigeminal neuralgia that can achieve a definitive cure.

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Trigeminal neuralgia symptoms

Regarding the symptoms of trigeminal neuralgia, there is a very typical symptom, which is the issue of trigger points. A trigger point is a specific spot on the face, which varies for each person. Once this spot is touched, it immediately triggers the pain of trigeminal neuralgia. The nature of trigeminal neuralgia pain is often like cutting or stabbing pain, and the duration varies. If the condition is mild, the initial attack may only last a few seconds, but if the condition gradually worsens without significant improvement, the pain can even last for several minutes. This pain significantly impacts patients, sometimes triggering pain during activities such as brushing teeth, rinsing the mouth, or chewing hard food. Early treatment is essential to mitigate this pain.