Due to the poor availability of this treatment in Poland, microvascular decompression (MVD) technique is still in use, consisting of craniotomy followed by elimination of the vasculoneural conflict by means of separating the problematic artery or vain from the nerve using autogenic (muscle fragment) or alloplastic (teflon, goretex) material [ 5, 8, 10, 14, 32].
Microvascular decompression improved arterial hypertension in some of these patients [20 22].
A surgical approach is reserved for refractory cases and consists in microvascular decompression or neural and geniculate ganglion transaction (3).
In microvascular decompression, a retromastoid craniotomy is performed after which the vessel(s) compressing the nerve are dissected off.
Patients that were treated with microvascular decompression were routinely seen in the outpatient clinic at the Department of Neurosurgery 3 months after surgery.
Microvascular decompression of the trigeminal nerve in medically intractable SUNCT and SUNA in patients that demonstrate aberrant arterial loop imprint could be effective [10].
There is some evidence supporting microvascular decompression of the trigeminal nerve in selected patients who have medically refractory SUNCT and a demonstrable ipsilateral aberrant vessel on magnetic resonance imaging (MRI).
Neurovascular contact (NVC) is considered a frequent cause of classical trigeminal neuralgia (TN) and transposition of a blood vessel in the potentially dangerous procedure of microvascular decompression is considered over other surgical options in medically refractory TN.
Among skull base surgeries (Table 2), cardiac emergencies were mainly reported in pituitary surgeries, microvascular decompression (MVD), and ablative procedures for trigeminal neuralgia [ 12– 19, 19, 24, 57].
All the surgical treatments can result in nerve damage except microvascular decompression, which limits the application of these techniques.
