Microvascular Decompression for Trigeminal Neuralgia: Visualization of Results in a 3D Stereoscopic Virtual Reality Environment

Background: This study employs 3D stereoscopic virtual reality technology to demonstrate the surgical results of microvascular decompression (MVD) for trigeminal neuralgia. Patients/Material and Methods: 3D models were rendered by fusing CTA and MRI fast imaging employing steady state acquisition (FIESTA) modalities of both pre- and post-operative scans. The brainstem, trigeminal nerve root and relevant vasculature were extracted, superimposed, and co-registered to bony and ventricular anatomy. Results: 3 clinically successful MVD cases were evaluated for superior cerebellar artery (SCA) vessel displacement. Qualitative parameters included translational and rotational shift of the SCA, and distance decompressed from the trigeminal nerve root entry zone. Parameters were met in each case, with demonstration of vessel displacement and decompression of the nerve root. Conclusion: The 3D virtual-reality environment with stereoscopic visualization offers a method through which to visualize the results of MVD, and a potential reference point to evaluate cases of treatment failure or relapse.