Among the structures contained within your skull are twelve cranial nerves responsible for major functions including sight, smell, hearing, eye movement, balance, speech, and swallowing.

Several well-described disorders exist related to dysfunction of cranial nerves — usually caused by nearby blood vessels. These disorders are called vascular compression syndromes.

Dr. Woodall (and his partners at Georgia Neurological Surgery) is a leader in the Athens area for treating vascular compression syndromes. He offers both surgical and nonsurgical options, depending on the unique aspects of your condition.

Examples and Symptoms of Vascular Compression Syndromes         

The following disorders are examples of vascular compression syndromes and can sometimes be treated with microvascular decompression surgery:

  • Trigeminal neuralgia is a condition affecting the fifth cranial nerve, also known as the trigeminal nerve, which carries sensation from the face to the brain. Everyday activities such as chewing, talking, or brushing your teeth can trigger pain ranging from mild to severe. Trigeminal neuralgia affects women more than men and occurs more often in people older than 50. The condition may be caused as a result of aging, or by a tumor compressing the trigeminal nerve.  Some patients with multiple sclerosis(MS) can develop trigeminal neuralgia.  Most often, trigeminal neuralgia is believed to be caused by arterial compression/pulsatility from the superior cerebellar artery.
  • Hemifacial spasm is an involuntary muscle twitch on one side of your face related to dysfunction of the seventh cranial nerve (the facial nerve). Though hemifacial spasm can be caused by a tumor or an injury to the facial nerve, it may also be caused by irritation of the facial nerve at the root exit zone (REZ) by the anterior inferior cerebellar artery. Hemifacial spasm may force one of your eyelids to close shut or your lips to pucker. Unlike trigeminal neuralgia, hemifacial spasms are usually painless—but the spasms are involuntary and irritating. These spasms may interfere with daily life.  Surgery is sometimes an appropriate treatment when non-surgical treatment options have failed.
  • Glossopharyngeal neuralgia refers to recurring episodes of pain in the tonsils, throat, tongue, and ear, which are connected to the ninth cranial nerve, also known as the glossopharyngeal nerve. The condition, which is most common in people older than 40, can also cause speaking and swallowing difficulties. Episodes of glossopharyngeal neuralgia can be quite painful—they are described as feeling like electric shocks in the throat, ear, or tongue—and may be triggered by everyday activities such as coughing and swallowing. In select cases, surgical treatment may be indicated.

Treatment for Vascular Compression Syndromes

Some vascular compression syndromes respond to medication, but surgery is sometimes necessary for those who fail medical management. Microvascular decompression (MVD) is a surgical procedure used to treat vascular compression syndromes. 

MVD is performed under general anesthesia and requires a craniotomy, which involves a small opening (about the size of a silver dollar) behind the ear. Under microscopic visualization, the blood vessel that is irritating the nerve is moved and a small pad may be placed between the vessel and nerve to relieve the pressure. A thin mesh will replace the bone where the hole was made.

You will likely remain in the hospital for two days or so following surgery. The most common complications of MVD (performed through a retrosigmoid approach) are infection, bleeding, and cerebrospinal fluid leak.  Hearing loss may also occur.

Dr. Woodall’s fellowship experience included a broad exposure to the surgical treatment of vascular compression neuropathies of the cranial nerves and brainstem. Dr. Woodall is also pleased to offer stereotactic radiosurgery (focused radiation, without the need for a skin incision) for appropriately selected patients with trigeminal neuralgia. A background in cerebrovascular and skull base surgery is the perfect skill set for dealing with vascular compression syndromes at the brainstem.

Contact M. Neil Woodall, MD, Today

If you have been diagnosed with trigeminal neuralgia, hemifacial spasm, or glossopharyngeal neuralgia, or if you have questions about the surgical treatment of these disorders — Dr. Woodall has the skill, care, and experience to ensure you receive the treatment you need—without leaving the Athens area. Contact our office today.