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microvascular decompression
Microvascular decompression (MVD), also known as the Jannetta procedure,〔http://neurosurgery.ucsf.edu/index.php/pain_treatment_trigeminal_neuralgia.html#MVD〕 is a neurosurgical procedure used to treat trigeminal neuralgia, a pain syndrome characterized by severe episodes of intense facial pain, and hemifacial spasm.
==History==
Nicholas Andre first described trigeminal neuralgia in 1756. In 1891 Sir Victor Horsley proposed the first open surgical procedure for the disorder involving the sectioning of preganglionic rootlets of the trigeminal nerve. Walter Dandy in 1925 was an advocate of partial sectioning of the nerve in the posterior cranial fossa. During this procedure he noted compression of the nerve by vascular loops, and in 1932 proposed the theory that trigeminal neuralgia was caused by compression of the nerve by a blood vessel.〔Dandy WE. Trigeminal neuralgia and trigeminal tic douloureux. In: Lewis D, ed. Practice of Surgery. Hagerstown, MD: WF Prior CO, 1932: 177-200.〕 With the advent of the operative microscope, Peter Jannetta was able to further confirm this theory in 1967 and advocated moving the offending vessel and placing a sponge to prevent the vessel from returning to its native position as a treatment for trigeminal neuralgia.〔Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. Journal of Neurosurgery 1967: 26: 159-162.〕
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