Advanced age as a contraindication to microvascular decompression for drug-resistant trigeminal neuralgia: evidence of prejudice?

Neurol Sci. 2010 Feb;31(1):23-8. doi: 10.1007/s10072-009-0156-1. Epub 2009 Oct 6.


Due to the alleged higher risk of complications of microvascular decompression for trigeminal neuralgia in elderly we evaluated its age-related results. A retrospective analysis of clinical outcome and complications was performed in 476 patients affected by drug-resistant trigeminal neuralgia who underwent microvascular decompression. As much as 117 patients older than 65 years (Group 1) and 359 under the age of 65 (Group 2) were followed-up for a period of 7-138 months. Pain relief was complete without medication in 84.5% in Group 1. Morbidity included slight trigeminal hypoesthesia in 5.8%; severe hearing loss in 0.9%; CSF leakage in 4.2%; transient diplopia in 3.4%; and posterior fossa subdural hematoma in 0.8% of these patients. Mortality was null. No statistically significant differences were observed between Groups 1 and 2. These findings seem to support the idea that microvascular decompression is not a dangerous surgical procedure in patients over the age of 65 years.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging*
  • Contraindications
  • Decompression, Surgical*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microvessels / surgery*
  • Middle Aged
  • Pain / drug therapy
  • Pain / surgery
  • Postoperative Complications
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Trigeminal Neuralgia / drug therapy
  • Trigeminal Neuralgia / surgery*
  • Young Adult