Abstract
Objective: To determine neuro-vascular conflicts as causative agent in idiopathic
trigeminal neuralgia.
Material and Methods: This prospective observational study was conducted in
department of neurosurgery, Lady Ready Hospital Peshawar, from May 2003 to April
2007. Resistant idiopathic trigeminal neuralgia cases were included in the study. After
detailed clinical and radiological examination, all underwent microvascular
decompression.
Result: Eighty Six patients were operated. There were 54 male and 32 female patients
with age ranging from 43-58 years. Microvascular compression was performed in 79
patients while rests of patient’s were having other causative factor. Maxillary division
involvement was recorded in 73.25% cases. Distribution of involvement of side in
trigeminal neuralgia (TN) was: right side TN (53.48%), left side TN (44.18%) and
bilateral in 2.32% patients. Absent arterial loop was recorded in 76 cases, of those three
patients were having absent veins. Superior cerebellar artery was noted as conflicting
agent in 61 patients and anterior inferior cerebellar artery in 20 cases. Basilar artery was
seen in one patient as compression element.
Conclusion: Idiopathic trigeminal neuralgia is commonly the result of aberrant vascular
loop compression. Superior cerebellar and anterior inferior cerebellar arteries are
common vessel of the compression. (Rawal Med J 2008;33:33-35).

Key words: Trigeminal neuralgia, micro vascular decompression, micro vascular conflict.