Abstract
The treatment option for medically intractable trigeminal neuralgia includes block, radiofrequency thermocoagulation, Gamma Knife surgery, and microvascular decompression. In this article, we compared the results after microvascular decompression and Gamma Knife surgery, using the same scoring system. Out of 203 cases of medically intractable trigeminal neuralgia, 59 cases of Gamma Knife surgery and 75 cases of microvascular decompression were evaluated for more than 1 year after the procedure with the Japan Society for Microvascular Decompression Surgery Postoperative Scoring System. Microvascular decompression offered a better result for pain control than Gamma Knife surgery did. However, microvascular decompression is known to have serious complications that may last more than 1 year after surgery, such as hearing disturbance, visual disturbance because of dry eyes, and gait disturbance by cerebellar injury. Although there was no perioperative complication in Gamma Knife surgery, more frequent facial numbness was noted than with microvascular decompression. Subsequently, microvascular decompression provided better result than Gamma Knife surgery in total comprehension. Therefore microvascular decompression is considered to be a better choice for medically intractable trigeminal neuralgia.
