{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T04:04:53Z","timestamp":1751083493297,"version":"3.41.0"},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nTrigeminal neuralgia (TN) is often treated with microvascular decompression (MVD), providing long-term pain relief for most patients. However, a subset experiences recurrence requiring reoperation. Endoscopic MVD techniques have gained traction due to enhanced visualization and potentially lower morbidity, yet their feasibility for redo procedures \u2013 particularly in complex cases with dense adhesions \u2013 remains uncertain.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nWe report the case of a 63-year-old male who initially presented with Barrow Neurological Institute (BNI) grade V TN in the V2\u2013V3 distribution. After an endoscopic MVD, the patient achieved immediate pain relief (BNI I) but developed recurrent symptoms 10 months later (BNI III), controlled by carbamazepine. A subsequent escalation (BNI IV) prompted surgical re-exploration. Imaging revealed no residual or new neurovascular conflict. Instead, intraoperative findings demonstrated dense adhesions tethering the trigeminal nerve to the tentorium, causing nerve tension. Careful endoscopic dissection restored nerve mobility and resulted in complete symptom resolution.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThis case highlights the feasibility and effectiveness of a fully endoscopic redo MVD in recurrent TN where dense adhesions, rather than persistent vascular compression, were the primary mechanism of recurrence. Further investigation is warranted to optimize endoscopic techniques, reduce adhesion formation, and improve long-term outcomes in redo MVD cases.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_262_2025","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T09:39:50Z","timestamp":1751017190000},"page":"260","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of redo endoscopic microvascular decompression for recurrent trigeminal neuralgia: An illustrative case"],"prefix":"10.25259","volume":"16","author":[{"given":"Shayakhmet","family":"Makhanbetkhan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Hospital of Medical Center of the President\u2019s Affairs Administration, Almaty, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuminari","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marat","family":"Sarshayev","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital of Medical Center of the President\u2019s Affairs Administration, Almaty, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mynzhylky","family":"Berdikhojayev","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital of Medical Center of the President\u2019s Affairs Administration, Almaty, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"10.25259\/SNI_262_2025\/ref-1","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3171\/2023.9.JNS231473","article-title":"Long-term outcome of microvascular decompression for typical trigeminal neuralgia with autologous muscle: An analysis of 1025 patients from a developing country","volume":"141","author":"Ashraf","year":"2024","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_262_2025\/ref-2","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/ene.13950","article-title":"European academy of neurology guideline on trigeminal neuralgia","volume":"26","author":"Bendtsen","year":"2019","journal-title":"Eur J Neurol"},{"key":"10.25259\/SNI_262_2025\/ref-3","doi-asserted-by":"crossref","first-page":"738032","DOI":"10.3389\/fneur.2021.738032","article-title":"Recurrence rates after microvascular decompression in patients with primary trigeminal neuralgia and its influencing factors: A systematic review and meta-analysis based on 8,172 surgery patients","volume":"12","author":"Chen","year":"2021","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_262_2025\/ref-4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1227\/00006123-199410000-00012","article-title":"Repeat operations in failed microvascular decompression for trigeminal neuralgia","volume":"35","author":"Cho","year":"1994","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_262_2025\/ref-5","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.wneu.2021.11.129","article-title":"A systematic review of repeat microvascular decompression for recurrent or persistent trigeminal neuralgia","volume":"158","author":"Jiao","year":"2022","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_262_2025\/ref-6","doi-asserted-by":"crossref","first-page":"687945","DOI":"10.3389\/fneur.2021.687945","article-title":"Long-term retrospective analysis of re-do microvascular decompression in patients with hemifacial spasm","volume":"12","author":"Liu","year":"2021","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_262_2025\/ref-7","first-page":"341","article-title":"Microvascular decompression for trigeminal neuralgia: The importance of a noncompressive technique--Kaplan-Meier analysis in a consecutive series of 330 patients","volume":"63","author":"Sindou","year":"2008","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_262_2025\/ref-8","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.3171\/2023.11.JNS231658","article-title":"Transposition versus interposition method in microvascular decompression for trigeminal neuralgia: Midterm analysis of both techniques in a single-center study","volume":"140","author":"Uhl","year":"2024","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_262_2025\/ref-9","doi-asserted-by":"crossref","first-page":"36","DOI":"10.23736\/S0390-5616.22.05514-X","article-title":"Contact-free transposition and interposition techniques for trigeminal neuralgia: A systematic review","volume":"67","author":"Uhl","year":"2023","journal-title":"J Neurosurg Sci"},{"key":"10.25259\/SNI_262_2025\/ref-10","doi-asserted-by":"crossref","first-page":"3000605221080721","DOI":"10.1177\/03000605221080721","article-title":"Treatment of redo-microvascular decompression or internal neurolysis plus microvascular decompression for recurrent trigeminal neuralgia: A review of long-term effectiveness and safety","volume":"50","author":"Wang","year":"2022","journal-title":"J Int Med Res"},{"key":"10.25259\/SNI_262_2025\/ref-11","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jocn.2021.06.034","article-title":"Microscopic versus endoscopic microvascular decompression for the treatment of hemifacial spasm in China: A 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