Neurovascular decompression for trigeminal neuralgia in elderly patients.

The operative findings and outcomes of neurovascular decompression for trigeminal neuralgia were compared between patients aged 75 years and older (elderly group, 17 patients) and patients aged under 75 years (nonelderly group, 115 patients). There were no statistically significant differences in the operative findings or outcomes between the two groups, except in the percentage of patients who had been treated with carbamazepine. Neurovascular decompression for trigeminal neuralgia can be performed in elderly patients with the same operative results as in nonelderly patients. If other treatments (especially carbamazepine treatment) prove ineffective, neurovascular decompression should be considered in elderly patients before they become too old to undergo surgery. However, neurovascular decompression in elderly patients requires great care, as the venous system, including the superior petrosal vein, should be preserved and retraction of the cerebellum should be avoided whenever possible to maintain correct blood circulation in the cerebellum and brainstem.