IMMINENT PATHOLOGY IN MICROVASCULAR DECOMPRESSION FOR IDIOPATHIC TRIGEMINAL NEURALGIA

Objective: To know about the impending pathology in microvascular decompression for idiopathic trigeminal neuralgia. Methodology: This was a prospective observational study conducted in the Department of Neurosurgery, Lady Reading Hospital Peshawar, from 20th August 2012 to 25th august 2013. The clinical and the operative records of the patients were noted and demographics such as the age, sex, side of the lesion as well as the per-operative impending pathology i.e. compression by an artery, vein or distortion by adhesions or a combination of them compressing upon the trigeminal nerve root was recorded on a predesigned proforma. All patients undergoing surgery for idiopathic trigeminal Neuralgia were included in the study. Patients who had trigeminal neuralgia secondary to a mass lesion were excluded from the study. The data was expressed in percentages and was analyzed through SPSS version 16. Results: Total of 55 patients in the study period fulfilled the criteria. There were 28 males and 27 females with a male to female ratio approaching 1:1. The age range was from 28 to 73 years with a mean age of 54.6 years. In 56.4% the pathology was right sided and in 34.5% it was left sided while in 9.1% it was bilateral(operated unilateral at the time). The impending pathology was compression by an artery in 76.6%, by a vein in 21.6% or purely by adhesions in 1.6% of cases. Conclusion: compression by an artery is the most common pathology encountered in the microvascular decompression for trigeminal neuralgia.