Vascular compression of lower cranial nerves: observations using microsurgery, with particular reference to trigeminal neuralgia.

A new finding made possible by the use of the operating microscope in neurosurgery is discussed. Nineteen patients with trigeminal neuralgia have been explored, and in 14 of these vascular compression of the fifth nerve at its entry zone to the pons has been found. Relief of this vascular compression has caused cessation of pain in all these patients. In addition, one patient with hemifacial spasm, and one patient with glosso pharyngeal neuralgia, are reported; each of these also had vascular compression of the appropriate nerve causing the symptoms.