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 Jiang Fang Shuai

Neurosurgery

51sec

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trigeminal neuralgia area

The trigeminal nerve, being the fifth pair of cranial nerves, branches into three divisions after emerging from the skull. The first division is the ophthalmic division, which innervates the upper eyelid and superficial parts of the eye and forehead. The second division is the maxillary division, governing the cheek, upper lip, and gums. The third division is the mandibular division, which affects the lower lip and gums. Trigeminal neuralgia is pain that occurs in the areas innervated by the trigeminal nerve, typically affecting one side and primarily involving the second and third divisions, with the second being the most common and the third next, while the first division is rare. The pain of trigeminal neuralgia can be confined to the area of one division or can occur in two or all three divisions simultaneously.

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Written by Chen Yu Fei

Neurosurgery

48sec

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Should people with trigeminal neuralgia avoid certain foods?

Patients with trigeminal neuralgia need to be cautious about their diet. In daily life, try to avoid oily, spicy, and irritating foods, as these types of foods may trigger an attack of trigeminal neuralgia or make the existing attacks more frequent, thereby causing great pain to the patient. It is recommended to choose a light diet in daily life, low in salt and fat, especially for patients with high blood pressure or diabetes, who need to be more cautious. It may be beneficial to appropriately include some fresh vegetables and fruits in the diet, and it is also suggested to supplement with some multivitamin drugs, which might enhance the effects. If trigeminal neuralgia attacks frequently, it is still recommended to visit a local hospital in a timely manner and consider undergoing microvascular decompression surgery for treatment.

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Written by Guo Zhi Fei

Neurosurgery

45sec

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Trigeminal neuralgia is divided into several branches.

Trigeminal neuralgia is anatomically divided into three branches: the first branch is the ophthalmic branch, the second branch is the maxillary branch, and the third branch is the mandibular branch. The scope of pain can be used to roughly determine which branch is affected. Generally, pain located in the forehead area is caused by the first branch, the ophthalmic branch. Pain in the area from the tip of the nose to the lips is caused by the second branch, the maxillary branch. Pain from the lips to the angle of the jaw is caused by the third branch, the mandibular branch. Therefore, we can understand which branch is in pain by the distribution area and scope of the trigeminal neuralgia.

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Written by Chen Yu Fei

Neurosurgery

47sec

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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

Neurosurgery

33sec

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Is cold compress effective for trigeminal neuralgia?

Trigeminal neuralgia is a type of intense recurring pain in the facial areas distributed by the trigeminal nerve. When an attack occurs, the pain is unbearable for the patient. Clinically, besides immediately taking medication or opting for surgical treatments after stabilization, applying a cold compress can also alleviate symptoms. Placing a cold towel on the painful facial areas can relieve spasms and pain, improve local swelling, raise the pain threshold, and subsequently reduce the sensation of pain.