Features of examination and surgical treatment of patients with trigeminal neuralgia

Purpose: introduction of the examination protocol into neurosurgical practice and evaluation of the results of micro-vascular decompression of the trigeminal nerve root in patients with type I trigeminal neuralgia. Material and Methods. The results of 86 operations of microvascular decompression of the trigeminal nerve root in patients with primary trigeminal neuralgia were studied. The preoperative examination protocol for all patients included a general clinical examination, assessment of neurological status, brain MRI with contrast enhancement and a cranial nerve imaging program (CISS or FIESTA). Particular attention was paid to the criteria for the diagnosis of trigeminal neuralgia type I (classical), recommended by the International Headache Society (IHS) in the International Classification of Headache Disorder (ICHD-3, 2018). The pain syndrome was evaluated according to the Visual Analogue Scale (VAS)from 0 to 100 points before surgery, at the time of discharge of the patient from the hospital, after 6 months and after 1 year. Microvascular decompression was performed according to a standard technique using, in all cases, a retrosigmoid suboccipital access, under general anesthesia. A Russian-made fluoroplastic felt was used as a tread. In most cases (98%), the main surgical techniques for isolation of the trigeminal root were used. Results. The effectiveness of surgical treatment was 95% Conclusion. Patients with a diagnosis of trigeminal neuralgia require examination according to a specific protocol that allows you to determine the indications for surgical treatment. The expediency of surgical intervention (microvascular decompression of the trigeminal nerve root) in patients with type I trigeminal neuralgia has been shown.