The historical evolution of microvascular decompression for trigeminal neuralgia: from Dandy's discovery to Jannetta's legacy.

Acta neurochirurgica
Smruti K PatelJames K Liu

Abstract

Although the symptoms of trigeminal neuralgia (TN) have been well described throughout the history of medicine, its etiology was initially not well understood by most surgeons. The standard procedure used to treat TN today, microvascular decompression (MVD), evolved due to the efforts of numerous neurosurgeons throughout the twentieth century. Walter Dandy was the first to utilize the cerebellar (suboccipital) approach to expose the trigeminal nerve for partial sectioning. He made unique observations about the compression of the trigeminal nerve by nearby structures, such as vasculature and tumors, in TN patients. In the 1920s, Dandy unintentionally performed the first MVD of the trigeminal nerve root. In the 1950s, Palle Taarnhøj treated a TN patient by performing the first intentional decompressive procedure on the trigeminal nerve root solely through the removal of a compressive tumor. By the 1960s, W. James Gardner was demonstrating that the removal of offending lesion(s) or decompression of nearby vasculature alleviated pressure on the trigeminal nerve and the pain associated with TN. By the 1990s, Peter Jannetta proved Dandy's original hypothesis; he visualized the compression of the trigeminal nerve at the root entry zon...Continue Reading

References

May 1, 1984·Neurosurgery·R L Pinkus
Apr 25, 1996·The New England Journal of Medicine·F G BarkerH D Jho
Apr 1, 1953·Cleveland Clinic Quarterly·W J GARDNER, J P PINTO
May 1, 1954·Journal of Neurosurgery·P TAARNHØJ
Aug 8, 1959·Journal of the American Medical Association·W J GARDNER, M V MIKLOS
Nov 1, 1962·Journal of Neurosurgery·W J GARDNER
Jul 13, 2004·Neurosurgery Clinics of North America·James K Liu, Ronald I Apfelbaum
Jan 1, 1949·Acta Psychiatrica Et Neurologica·H OLIVECRONA
May 26, 2005·Neurosurgical Focus·Chad D ColeRonald I Apfelbaum
Oct 1, 1932·Annals of Surgery·W E Dandy
Jun 22, 2016·Neurosurgery Clinics of North America·Smruti K Patel, James K Liu

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