[Complications of the operative neurosurgical treatment of trigeminal neuralgia].

The complications after neurosurgical treatment of trigeminal neuralgia of 161 patients treated in the neurosurgical hospital university medical school Bonn from 1971 to 1974 are referred. Emphasis is layed on severe complications. After rhizotomia (Dandys method) 3 patients died, one of them because of a meningitis, one of them because of damage of the superior petrosal vein and one after ligature of an irregular auditive artery. One patient died after electrocoagulation of the ganglion Gasseri (Kirschner's method) after having had an important bleeding during coagulation. Another patient developed hemiparesis after a strong arterial bleeding during electrocoagulation. The damage of importance arterial vessels seems to be decisive. Three proposals in order to diminish the risk of the operations are settled: 1. Preoperative neuroradiological checks by means of contrast. 2. Carefully sparing of vessels, especially when precedent scars had alterated the field of operation, perhaps if necessary by means of the operation mikroscope. 3. Control of the lokalisation of the needle during electrocoagulation by X-rays.