Abstract
A man in his 50s had longstanding left-sided trigeminal neuralgia triggered by eating and brushing his teeth, which was refractory to maximal medical management. MRI fast imaging employing steady-state acquisition demonstrated left trigeminal nerve compression by the left superior cerebellar artery (figure). Therefore, the patient underwent a craniotomy for microvascular decompression (MVD). In select patients, MVD can be an effective treatment for trigeminal neuralgia.1,2 Prognostic indicators of long-term relief include male sex, immediate postoperative relief, and duration of symptoms for less than 8 years.1 The patient's adhered nerve was freed from the artery (video 1 at [Neurology.org][1]). Facial pain improved substantially in the immediate postoperative period. [1]: http://neurology.org/lookup/doi/10.1212/WNL.0000000000004746
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