In a number of patients with Trigeminal Neuralgia, the pain can be demonstrated to be due to compression of the trigeminal nerve roots as they emerge from the substance of the brain by a loop of artery. This artery, by pressing on the nerve, can cause degeneration of the insulating sheaths of the nerve fibres and this and other resultant changes can cause the nerves to start firing spontaneously, giving rise to the shooting pains of Trigeminal Neuralgia.
A neurosurgical operation called microvascular decompression, originally described by Janetta, can lift the artery away from the nerve roots and may be associated with a significant cure rate. This is illustrated well in this website.
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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
Page updated 19/02/2016