Weill Medical College of Cornell University

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• Parkinson's Disease and Other Movement Disorders
• Pain Treatment
• Trigeminal Neuralgia Treatment
• Functional and Stereotactic Neurosurgery
• Computer-assisted Stereotactic Microsurgery
• Interactive Image-guided Neurosurgery
• Movement Disorders Surgery
• Microvascular Decompression

Microvascular Decompression

Microvascular decompression is an effective microsurgery procedure to reposition the blood vessel that irritates a cranial nerve as it comes out of the brainstem. Conducted under general anesthesia, the procedure consists of making an incision behind the ear and then a small opening (about one inch) in the skull. This allows the surgeon to see where the blood vessel is pressing on the nerve. Once the area of compression is seen, the blood vessel(s) is separated from the nerve and a small pad is placed on the nerve to prevent further contact.

Microvascular decompression is effective in the treatment of:

• Hemifacial spasm
• Trigeminal neuralgia
• Intractable positional vertigo
• Tinnitus
• Spasmodic torticollis

Microvascular decompression has a very high success rate when performed by a qualified neurosurgeon, and complications are rare. It is very important that an experienced surgeon perform this procedure — there is often more than one blood vessel pressing on the nerve and all should be found. The neurosurgeons and neurologists of Weill Cornell Medical Center are highly skilled in this technique.

Recovery from this procedure is brief — most patients can be discharged from the hospital one or two days after surgery. Post-operative relief of symptoms is usually immediate, but in some cases it sputters for a matter of weeks before stopping permanently. Rarely, a delayed facial weakness occurs, but invariably it is temporary and transient. Late recurrence of the spasm is extremely rare. The occasional early recurrence reflects some technical error or an incorrect diagnosis.

Despite the high success rate from this surgery, it still carries serious potential risks, and a decision to undergo the procedure should be made with an understanding of its risks as well as the benefits. The most frequent complication is loss of hearing on the same side, but this occurs in less than 10% of patients and is usually slight.