Microvascular decompression is a surgical procedure for cranial nerve compression syndrome, most often carried out for trigeminal neuralgia, or less frequently hemifacial spasm and glossopharyngeal neuralgia.
It is usually carried out via a retrosigmoid craniotomy. The culprit blood vessel, either artery or sometimes a vein is identified abutting the nerve root entry zone and is mobilised away from the nerve. Small pads of woven Teflon R (pledgets) are introduced between the nerve from the vessel. These can be seen as hyperattenuating rectangular structures on CT and of low signal intensity on T2 weighted MRI scans.
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