Video: Microvascular Decompression for Trigeminal Neuralgia
Dr Nor Faizal performs microvascular decompression, repositioning a blood vessel compressing the trigeminal nerve, in this real operative video.
· Updated 1 March 2026
Watch: The Blood Vessel Compressing the Nerve
In this video, I show the surgery itself — microvascular decompression, where I reposition a blood vessel that is compressing the facial (trigeminal) nerve. This condition causes patients to suffer extreme facial pain and unusual sensitivity to pressure and touch.
What this video covers
- What trigeminal neuralgia feels like — sudden, severe, electric-shock-like facial pain, often triggered by touch, chewing, or even a breeze
- What causes it — a blood vessel compressing the trigeminal nerve near the brainstem
- How MVD relieves it — carefully separating the vessel from the nerve rather than damaging the nerve itself
- Why early diagnosis matters — an MRI can confirm vascular compression and rule out other causes
Key takeaways
Early diagnosis makes a significant difference to treatment outcomes. If you or a family member are experiencing persistent or worsening facial pain, please seek evaluation promptly.
When should I be concerned?
The symptoms below warrant prompt neurological assessment:
- Facial pain that is new and progressively worsening
- Sudden facial weakness or drooping
- Hearing loss
- Morning headaches accompanying facial symptoms
Frequently asked questions
What is microvascular decompression (MVD) surgery? Microvascular decompression is a surgical procedure that repositions a blood vessel that is compressing a cranial nerve, relieving the pressure that causes the nerve to misfire. It is most commonly performed for trigeminal neuralgia, where a blood vessel is found pressing on the trigeminal nerve near the brainstem.
What causes trigeminal neuralgia? Trigeminal neuralgia is most often caused by a blood vessel compressing the trigeminal nerve at the point where it exits the brainstem, wearing away its protective coating over time. This causes sudden, severe, electric-shock-like facial pain, often triggered by light touch, chewing, or even a breeze on the face.
Is MVD surgery effective for trigeminal neuralgia? Yes, for well-selected patients with a confirmed vascular compression, microvascular decompression offers among the highest long-term pain relief rates of any treatment for trigeminal neuralgia, and unlike ablative procedures, it does not intentionally damage the nerve.
How is trigeminal neuralgia diagnosed? Diagnosis is based on the characteristic pattern of sudden, severe, one-sided facial pain, supported by an MRI to look for a blood vessel compressing the trigeminal nerve and to rule out other causes such as a tumour or multiple sclerosis.
Book a consultation
If you or a family member are experiencing facial pain like this, book an appointment to get my assessment.
Book an appointment at Tawakkal Specialist Hospital, Kuala Lumpur.