Brain Surgery

Trigeminal Neuralgia Surgery in Los Angeles

Depending on the nature of your condition, get elite care with Microvascular Decompression, Stereotactic Radiosurgery (Gamma Knife), or Percutaneous Rhizotomy / Balloon Compression.
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WHAT IS Microvascular Decompression (MVD)?

Microvascular Decompression is a microsurgical procedure used to relieve pressure on the trigeminal nerve, typically caused by a blood vessel pressing against it. This pressure disrupts the normal function of the nerve, resulting in intense facial pain. MVD is performed through a small incision behind the ear, and once the vessel is gently moved away from the nerve, a soft cushion (usually a Teflon pad) is placed between the two to prevent future contact. This surgery offers the potential for long-term pain relief without damaging the nerve.

WHAT IS Stereotactic Radiosurgery (Gamma Knife)?

Stereotactic radiosurgery, commonly known as Gamma Knife, is a non-invasive technique that uses highly focused beams of radiation to target the trigeminal nerve root. The radiation alters the nerve’s ability to transmit pain signals, providing relief without the need for a surgical incision. Gamma Knife is an ideal solution for patients who are not candidates for open surgery or who prefer a less invasive approach. It’s typically performed in a single outpatient session, with pain relief developing gradually over several weeks to months.

WHAT IS Percutaneous Rhizotomy?

Percutaneous Rhizotomy includes several minimally invasive techniques, such as balloon compression, glycerol injection, or radiofrequency ablation, designed to interrupt pain signals in the trigeminal nerve. These procedures are done under local anesthesia and involve inserting a needle through the cheek to reach the trigeminal nerve. Balloon compression temporarily squeezes the nerve, while other methods use chemicals or heat to reduce its activity. These options are typically reserved for patients who have not found relief with medication or are not suitable candidates for more invasive surgery.

When Is Trigeminal Neuralgia Surgery Recommended?

Surgical treatment may be recommended when:

  • Medications like carbamazepine or oxcarbazepine are no longer effective
  • Side effects from medication are intolerable
  • You experience breakthrough pain despite medical therapy
  • The pain significantly interferes with daily activities, eating, or speaking
  • Imaging suggests a vascular compression of the trigeminal nerve
  • You prefer long-term relief without reliance on daily medications

Trigeminal neuralgia surgeries are used to treat:

  • Classic trigeminal neuralgia (Type 1)
  • Atypical facial pain with a trigeminal nerve origin
  • Secondary trigeminal neuralgia caused by multiple sclerosis or tumors
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What to Expect During 
Trigeminal Neuralgia Surgery

Microvascular Decompression (MVD)

Anesthesia

MVD is performed under general anesthesia.

Surgical Access

A small incision is made behind the ear, and a craniotomy is performed to expose the trigeminal nerve at the brainstem.

Decompression

Using microsurgical techniques, the blood vessel compressing the nerve is gently separated, and a Teflon pad is placed to prevent future contact.

Recovery

Hospital stay is typically two to three days, with a return to most activities in a few weeks. Pain relief is often immediate and long-lasting.

Gamma Knife Radiosurgery

Preparation

A head frame is placed to precisely target the nerve. Imaging (MRI or CT) guides treatment planning.

Procedure

The patient lies comfortably in the Gamma Knife unit while focused radiation is delivered in a single outpatient session.

Recovery

Most patients go home the same day. Pain relief occurs gradually over a period of weeks or months.

Percutaneous Rhizotomy

Anesthesia

These procedures are done under local anesthesia with light sedation.

Accessing the Nerve

A needle is inserted through the cheek and guided to the trigeminal nerve using X-ray imaging.

Nerve Disruption

Balloon compression inflates a small balloon to compress the nerve. Other methods may involve heating (radiofrequency) or injecting medication (glycerol) to selectively damage pain fibers.

Recovery

Same-day discharge is common. Some facial numbness may occur but it is often preferable to ongoing pain.

Frequently Asked Questions

FAQs About Trigeminal Neuralgia Surgery

Which surgery is right for me?
The best surgical option depends on your health, age, MRI findings, and personal preference. Dr. Yashar will review your history and imaging to guide you toward the most appropriate treatment.
How successful is MVD?
Microvascular Decompression offers long-term relief in 70 to 90% of patients with classic trigeminal neuralgia, especially when a compressing vessel is identified.
Does Gamma Knife have side effects?
It is minimally invasive and well tolerated. Some patients may develop mild facial numbness, which is usually temporary.
Is percutaneous rhizotomy permanent?
These procedures can provide relief for months to years. They may need to be repeated if pain returns, but they are quick and minimally invasive.
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Where to Find the Best Trigeminal Neuralgia Surgeon in Los Angeles

Trigeminal neuralgia is one of the most painful conditions known, but you don’t have to live with the agony. At Parham Yashar Neurosurgery, we combine expert diagnostics with advanced surgical solutions to offer you lasting relief.

Whether you need microvascular decompression, Gamma Knife radiosurgery, or a minimally invasive rhizotomy, Dr. Parham Yashar provides the precision and experience necessary to restore your quality of life. As one of Los Angeles’s leading neurosurgeons for facial pain, Dr. Yashar is board-certified, fellowship-trained, and takes a compassionate, personalized approach to help you reclaim your pain-free days.

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Los Angeles
8436 W. 3rd St.
Suite 800
Los Angeles, CA 90048(424) 209-2669
Hours:
Monday - Friday
8am - 5pm
Las Vegas
201 N. Buffalo Dr.
Las Vegas, NV  89145(702) 86-SPINE
Hours:
Monday - Friday
9am - 4pm