Microvascular Decompression Dr. Peter Jennetta established cause of tic douloureaux when he confirmed earlier observations that these patients usually had a small artery or vein compressing the nerve in the posterior skull. He developed microvascular decompression as an effective treatment. Under general anesthesia a small window of bone is removed from behind the ear to gain entry to the lower brain stem and trigeminal nerve. Under a microscope the surgeon separates the blood vessel from the nerve and places a cushion of Teflon cotton between them. An overnight stay in the intensive care unit and a few days hospitalization are required.
Rare complications are deafness, cerebrospinal leak and other complications of open surgery.
Gamma Knife Radiosurgery Gamma Knife radiosurgery can successfully treat tic pain. Transient facial numbness is rare. Long term recurrence rates are unknown. This treatment is a suitable alternative to anticonvulsant therapy and compares favorably to other treatments. Read the personal experience of a patient during and after her Gamma Knife treatment submitted to the Trigeminal Neuralgia Association, San Diego Support Group.