A vascular compression syndrome occurs when an artery in the brain compresses a nerve in the head. This compression injures the nerve, resulting in a short circuit of nerve impulses. Depending on the nerve affected, facial pain (trigeminal neuralgia), involuntary facial movement (hemifacial spasm), or deep ear or throat pain (glossopharyngeal neuralgia) may occur. Facial pain is the most common symptom.
The first line of treatment is medication, as it is generally effective and poses little risk. Medications used for vascular compression syndromes are often the same as those used for treatment of epilepsy. Medical therapy is generally well tolerated and usually effective for years. In cases where medicine fails or side effects are intolerable, surgery may be considered.
The surgical treatment for trigeminal neuralgia has evolved over the years into two groups: Rhizotomy or radiofrequency procedures, which result in alteration in the nerve to change conduction; and microsurgical procedures, which displace the pressing blood vessel and correct the underlying cause of the nerve dysfunction.
At Lahey Hospital & Medical Center we have extensive experience and expertise in treating these disorders. Radiofrequency and microsurgery procedures are both offered. The type of surgical treatment is individualized according to the needs of each patient, taking the patient's age, and overall health into paramount consideration. When medicine does not provide sufficient relief, surgery provides an effective option for many patients with trigeminal neuralgia.