{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T08:17:25Z","timestamp":1778228245347,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The relationship between the duration of trigeminal neuralgia (TN) symptoms prior to initial microvascular decompression (MVD) and long\u2010term outcomes is unclear. We evaluated whether the pre\u2010operative symptom duration is associated with complete freedom from pain when MVD is performed as the initial procedure in TN secondary to arterial compression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with purely paroxysmal TN who underwent MRI were retrospectively classified as cTN or iTN. Patients in each subtype of TN were categorized into pre\u2010operative symptom duration groups of\u2009\u2264\u200924\u2009months, 24\u201348\u2009months, 48\u201372\u2009months, or\u2009\u2265\u200972\u2009months. Univariate and multivariate analyses were conducted for each subtype of TN. The first subgroup (i.e., \u2264\u200924\u2009months) was treated as the reference subgroup for multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At a median follow\u2010up of 62.9\u2009months (28.9\u201397.6\u2009months), 15 (71.4%), 18 (100%), 12 (80.0%), and 13 (76.5%) MVDs for cTN with morphological changes resulted in pain freedom without medication in the\u2009\u2264\u200924, 24\u201348, 48\u201372, and\u2009\u2265\u200972\u2009months symptom duration groups, respectively. At a median follow\u2010up of 71.4\u2009months (21.2\u201371.4\u2009months), 8 (100%), 16 (94.1%), 10 (90.9%), and 8 (80.0%) MVDs for iTN morphological changes resulted in pain freedom without medication in the\u2009\u2264\u200924, 24\u201348, 48\u201372, and\u2009\u2265\u200972\u2009months symptom duration groups, respectively. Multivariate analysis showed no difference in outcomes between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>MVD performed later in the disease course is equally effective when compared to early MVD as the initial surgical procedure for the management of cTN <jats:italic>with morphological changes<\/jats:italic> and iTN <jats:italic>without morphological changes<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70184","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T09:14:03Z","timestamp":1749114843000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010Term Effectiveness of Early Versus Late Microvascular Decompression for Trigeminal Neuralgia Secondary to Arterial Compression"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-7764","authenticated-orcid":false,"given":"Raviteja","family":"Bethamcharla","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna S.","family":"Yugrakh","sequence":"additional","affiliation":[{"name":"Department of Neurology Columbia University Vagelos College of Physicians and Surgeons  New York New York USA"},{"name":"Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue\u2010Fang","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Raymond F.","family":"Sekula","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Columbia University Medical Center  New York New York USA"},{"name":"Department of Neurology Columbia University Vagelos College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002840"},{"key":"e_1_2_13_3_1","unstructured":"International Headache Society International Classification of Headache Disorders\u20103 https:\/\/ichd\u20103.org\/13\u2010painful\u2010cranial\u2010neuropathies\u2010and\u2010other\u2010facial\u2010pains\/13\u20101\u2010trigeminal\u2010neuralgia\/."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.14156"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.JNS142086"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awu349"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604253341701"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.59.8.1297"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.1.59"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyz075"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS-07\/12\/1144"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.9.17660"},{"key":"e_1_2_13_13_1","first-page":"1","article-title":"Significance of Degree of Neurovascular Compression in Surgery for Trigeminal Neuralgia","volume":"133","author":"Hughes M. 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