Microvascular nerve compression syndromes are often caused by compression of the cranial nerves at the root entry zone of the brain stem by blood vessels. Trigeminal Neuralgia (TN), Glossopharyngeal Neuralgia, and Hemifacial Spasm are the most often encountered syndromes.
Boulder Neurosurgical & Spine Associates (BNA) is one of the only centers in the region that uses the most advanced technologies and multidisciplinary approaches treating these syndromes. BNA’s Trigeminal Neuralgia program is devoted entirely to the treatment of such pain that occurs in the trigeminal nerve innervation zones. In most cases, this is caused by chronic vascular compression, which results in demyelination and subsequent pathological changes. If conservative treatment does not relieve the symptoms, or patients cannot tolerate medications, a surgical procedure can be performed called Microvascular Decompression (MVD).
Sometimes trigeminal pain can be caused by a lesion (e.g. tumor), or trauma. Therefore, it is important to establish the underlying cause of pain and eliminate, if possible.
Figure: CyberKnife radiosurgery treatment plan shows the distribution of radiation doses (left) and MRI scan (right) after the treatment demonstrate the anterior portion of the trigeminal nerve affected by highly focused radiation.
BNA surgeons offer alternative treatment options, CyberKnife radiosurgery, to patients that are not ideal candidates for a microvascular decompression due to significant comorbidities or other issues that increase surgery risk . These patients now have an alternative treatment option, which does not even require an incision and is virtually pain-free. BNA surgeons published a landmark paper on CyberKnife Radiosurgery for Trigeminal Neuralgia that has literally changed the standard of care.