{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T13:14:49Z","timestamp":1793970889841,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1988,4]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Thirty-five patients with trigeminal neuralgia (TN) bilaterally underwent posterior fossa microvascular decompression (MVD) between 1971 and 1984. They comprised 5.0% of a larger series of 699 patients with TN who underwent MVD during that interval. Compared to the subgroup of 664 patients with only unilateral symptoms, the population with bilateral TN included a greater percentage of females (74% vs. 58%, p &lt; 0.1), a higher rate of \u201cfamilial\u201d TN (17% vs. 4.1%, p &lt; 0.001), and an increased incidence of additional cranial nerve dysfunction (17% vs. 6.6%, p &lt; 0.05) and hypertension (34% vs. 19%, p &lt; 0.05).<\/jats:p>\n<jats:p content-type=\"fine-print\">Of the 35 patients with bilateral TN, 10 underwent bilateral MVD (22 procedures) and 25 underwent unilateral MVD (30 procedures). In the latter patients, pain on the nonoperative side was well controlled with medication alone or had previously been treated by ablative procedures. Good or excellent pain control was achieved after one MVD was performed in 40 of the 45 sides treated (89%), and was maintained 1, 5, and 10 years after surgery in 82%, 66%, and 60%, respectively, based on life-table analysis. Six of 10 patients with recurrent symptoms underwent repeat unilateral MVD. Good or excellent long-term pain control was maintained in all six. With these repeat procedures included, symptom control at 1, 5, and 10 years after initial surgery was maintained in 87%, 78%, and 78% of the treated sides, respectively. Overall, 26 of 35 patients (74%) maintained good or excellent pain relief throughout the duration of the study (mean follow-up period 75 months) without resumption of regular medication usage. Although preoperative neurological deficits resulting from previous ablative procedures were seen in the majority of patients before MVD, no patient developed new major trigeminal sensory loss or masseter weakness after MVD. Operative mortality was zero. The results indicate that posterior fossa MVD is an effective and relatively safe treatment for the majority of patients with bilateral \u201cidiopathic\u201d TN, avoiding the risks of bilateral trigeminal nerve injury seen with other approaches.<\/jats:p>","DOI":"10.3171\/jns.1988.68.4.0559","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:17:34Z","timestamp":1241799454000},"page":"559-565","source":"Crossref","is-referenced-by-count":79,"title":["Bilateral trigeminal neuralgia: a 14-year experience with microvascular decompression"],"prefix":"10.3171","volume":"68","author":[{"given":"Ian F.","family":"Pollack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Jannetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Bissonette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","first-page":"601","volume":"35","author":"Adson AW","year":"1926","journal-title":"Ann Otol"},{"key":"b2","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1001\/archneurpsyc.1938.02270110173014","volume":"40","author":"Allan W","year":"1938","journal-title":"Arch Neurol Psychiatry"},{"key":"b3","first-page":"42","volume":"54","author":"Bailey T","year":"1921","journal-title":"J Nerv Ment Dis"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(72)90289-7"},{"key":"b5","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/00000441-192008000-00001","volume":"160","author":"Cushing H","year":"1920","journal-title":"Am J Med Sci"},{"key":"b6","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1212\/WNL.23.9.937","volume":"23","author":"Daly RF","year":"1973","journal-title":"Neurology"},{"key":"b7","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1001\/archsurg.1929.04420030081005","volume":"18","author":"Dandy WE","year":"1929","journal-title":"Arch Surg"},{"key":"b8","volume-title":"Practice of Surgery.","volume":"12","author":"Dandy WE","year":"1945"},{"key":"b9","first-page":"511","volume":"89","author":"Ectors L","year":"1953","journal-title":"Rev Neurol"},{"key":"b10","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1097\/00000658-193410000-00018","volume":"100","author":"Frazier CH","year":"1934","journal-title":"Ann Surg"},{"key":"b11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/neurosurgery\/15.CN_suppl_1.1","volume":"15","author":"Gardner WJ","year":"1968","journal-title":"Clin Neurosurg"},{"key":"b12","first-page":"264","volume":"45","author":"Gurdjian ES","year":"1959","journal-title":"Surgery"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/63.3.209"},{"key":"b14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/00000658-193602000-00002","volume":"103","author":"Harris W","year":"1936","journal-title":"Ann Surg"},{"key":"b15","doi-asserted-by":"crossref","unstructured":"Harris W:Neuritis and Neuralgia.New York: Oxford Medical Publications, 1926, p 394","DOI":"10.1016\/S0140-6736(00)45254-2"},{"key":"b16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1136\/bmj.1.5531.7","volume":"1","author":"Henderson WR","year":"1967","journal-title":"Br Med J"},{"key":"b17","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1001\/archneur.1980.00500540063007","volume":"37","author":"Herzberg L","year":"1980","journal-title":"Arch Neurol"},{"key":"b18","first-page":"394","volume":"61","author":"Horrax G","year":"1935","journal-title":"Surg Gynecol Obstet"},{"key":"b19","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1093\/neurosurgery\/26.CN_suppl_1.607","volume":"26","author":"Jannetta PJ","year":"1979","journal-title":"Clin Neurosurg"},{"key":"b20","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1159\/000428328","volume":"7","author":"Jannetta PJ","year":"1976","journal-title":"Prog Neurol Surg"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198010000-00010"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1982.tb03076.x"},{"key":"b23","first-page":"296","volume-title":"Headaches and Cranial Neuralgias. 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