Who is a candidate for MVD?

Patients with classic trigeminal neuralgia, MRI evidence of vascular compression, persistent pain or medication side effects, and fitness for anesthesia.

Risks include bleeding, infection, CSF leak, hearing changes, facial weakness or numbness, stroke (rare), and anesthesia risks.

What are the alternatives to MVD?

Radiosurgery and percutaneous rhizotomy are alternatives; medication optimization may also help. Choice depends on MRI, health, and preferences.

Microvascular Decompression (MVD) in Hyderabad

Microvascular decompression (MVD) is a microsurgical procedure used in selected patients with classic trigeminal neuralgia (TN), where a blood vessel presses on the trigeminal nerve. The goal is to separate the vessel from the nerve using a small cushion, aiming for durable pain relief without intentionally injuring the nerve. Suitability depends on your symptoms, MRI findings, and overall fitness.

Who is a candidate?

Classic, shock-like facial pain in V1/V2/V3 distributions with pain-free intervals
MRI suggests vascular contact/compression at the trigeminal root entry zone
Adequate trial of medicines (e.g., carbamazepine/oxcarbazepine) with persistent pain or side effects
Medically fit for general anesthesia and craniotomy

Pre-operative workup

Clinical evaluation to confirm TN pattern and rule out other causes
MRI brain with trigeminal sequences to assess vascular compression and exclude secondary causes
Anesthesia assessment and optimization of comorbidities

How MVD works (summary)

Small craniotomy behind the ear under general anesthesia
Microscope-guided separation of the offending artery/vein from the nerve
Placement of a cushion (e.g., Teflon) between vessel and nerve to prevent re-compression
Closure and monitored recovery

Benefits and risks

Potential Benefits

High rates of durable pain control in appropriate candidates
Motion and sensation of the face are preserved (nerve not intentionally injured)

Risks

Bleeding, infection, CSF leak
Hearing changes, facial weakness or numbness
Stroke (rare), anesthesia risks
Pain recurrence over time can occur

No surgery is risk-free. Alternatives exist if needed.

Alternatives we discuss

Stereotactic radiosurgery (Gamma Knife)

Non-incisional; pain relief may take weeks; facial numbness can occur

Percutaneous procedures

Radiofrequency/balloon/glycerol rhizotomy: day-care; often rapid relief; higher chance of facial numbness; durability varies

Medication optimization

Dose adjustments or adjuncts when tolerated

Recovery timeline (typical ranges; individualized)

Hospital

Usually 2–4 days

First 2 weeks

Rest, wound care, gentle walks; avoid heavy lifting/straining

Weeks 2–4

Gradual return to routine; we taper medicines as appropriate

Red flags

Fever, severe headache, wound fluid, hearing changes, double vision, new weakness—contact the team promptly.

Costs and insurance (Hyderabad)

Typically covered for indicated cases after pre-authorization
Written estimate provided after evaluation and MRI review
Final cost depends on room category, policy caps, and clinical needs

Why choose Dr Sayuj Krishnan

Expertise in TN evaluation and comprehensive management across MVD, radiosurgery, and percutaneous options
Safety-first protocols and clear counseling on benefits/risks and alternatives
Care at Yashoda Hospitals – Malakpet with structured follow-up

Book a Consultation

TN is highly treatable. We'll help you choose MVD, radiosurgery, or a percutaneous option based on your MRI and health. Book a consultation at Yashoda Hospitals – Malakpet and bring your MRI and medication list for a personalized plan.

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References

Disclaimer

Educational only; not a substitute for medical advice. Treatment is individualized after clinical evaluation and imaging. Outcomes vary; no guarantees.

Last medically reviewed: October 1, 2025 — Medical reviewer: Dr Sayuj Krishnan, MBBS, DNB Neurosurgery (Direct 6 years)