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What Causes Pain And Swelling In Brain Stem After A Microvascular Decompression?

Posted on Sat, 19 Jul 2014

Question: Hi I have glossopharyngeal neuralgia and 18months ago had microvascular decompression of the nerve which was supposed to be a success. Because of still having severe pain and hard swelling over my right brain stem area I have had another mri scan which shows still compression of coratoid? artery. The neurosurgin who operated will not operate again and I feel he has let me down terribly, I cannot lie on my brain stem area and severe headaches. My life is a misery and no explanation as to why it is still compressed and why it cannot be fixed . Kind Regards XXXXXXX XXXXXXX

Answered by Dr. Eris Ranxha (1 hour later)

Brief Answer:
Oral treatment

Detailed Answer:
Dear
I am sorry for the symptoms you are suffering
Unfortunately sometimes surgery isn't successful but this dosn't mean that there is no more hope
Second surgery isn't reccomended without trying oral therapy.
You should contact your neurologist and start using carbamazepine (till 1000 mg slowly increasing the dose)
Vascular neuralgia needs low blood pressure to avoid attacks.
I need you are suffering but there is still hope with the right medications and in my opinion you should avoid surgery as long as possible.
Hope my answer will help you
Don't hesitate to contact me for further questions
Best regards
Dr Eris Ranxha
Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Eris Ranxha (16 hours later)

I have had carbamazepine which caused severe headaches and I do take proprananol for the blood pressure along with valpronoate. The neurosurgin who operated said the 9th cranial nerve was hard to treat with meds if it was the 5th or 7th they have a lot of success with medications and recommended surgery with a 75% success rate that is why I went ahead with first lot of surgery. Why do you think it would be unwise for a second operation to relieve the pressure if it was not done properly in the first place. Kind Regards
XXXXXXX XXXXXXX

Answered by Dr. Eris Ranxha (23 minutes later)

Brief Answer:
High risk

Detailed Answer:
Dear
unfortunately second surgery has higher risk for complication.
Second side effects of tegretol can be dominated with the use of an pain killer
In my opinion you should start tegretol and wait for at least two months, if no effects are seen then second surgery it's to be done
Hope you will fine with tegretol
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar