What is included in the preoperative evaluation for trigeminal neuralgia (TN) surgery?

Updated: Sep 30, 2019
  • Author: Kim J Burchiel, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

When surgical procedures are contemplated, appropriate and routine preoperative laboratory tests are in order. In cases of typical (TN1) and atypical trigeminal neuralgia (TN)—referred to as TN1 and TN2, respectively—magnetic resonance imaging (MRI) of the brain with contrast is required to evaluate for vascular malformations or other lesions. MRI is sensitive for the exclusion of intracranial lesions, which can cause TN in rare cases. Devote particular attention to the posterior fossa. High-resolution imaging of the nerve at the brainstem entry zone may reveal vascular compression of the nerve. [7, 8]


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