AN removal after MVD for trigeminal neuralgia

[CHD63]

This is my first post so I hope someone shares help for my incorrect usage of this wonderful forum!     I have been reading posts for over a year now and they have been so very helpful and comforting!!

At my one-year-anniversary of the AN removal, I have reached a point where I have questions.

1)  Has anyone been through microvascular decompression surgery (via retrosigmoid approach) for trigeminal neuralgia, as well as AN removal?  I am still experiencing significant balance issues and wonder if it is related to having had surgeries on both sides.

2)  On my one-year-out MRI, it is showing an area that my neurosurgeon is not sure whether it is scar tissue or residual tumor (the radiologist says it is "compatible with residual tumor").  The recommendation is to wait a year for a follow-up MRI.  Any suggestions for how not to be concerned??   

[Dan]

Hello and welcome, I had retrosigmoid surgery (I don't know what microvascular decompression is) 18 months ago and at 12months post OP also had an MRI showing an area everyone said could be scar tissue or residual regrowth.  The radiologist said I should have another MRI in 3 months but I talked to a doctor from my surgery team and he said 3-6 months.  From what I have read here I think waiting a year would be good enough, but I am going to have the next MRI done in a couple of weeks.  How not to be concerned thats a good question.  I try not to think about it to much but of course haven't been able to completely block it out.  Wish me luck and I'll be wishing you luck to.    

Dan in Germany

[CHD63]

Thanks so much for your encouraging reply, Dan.  Microvascular decompression is relieving pressure from a vein or artery on a nerve.  In my case an artery was compressing the trigeminal nerve at the brainstem so it was raised up via teflon pads.  Two veins were also involved, which were clipped and I was told they would reroute.  Since the trigeminal nerve is so close to the auditory nerve, monitoring was done for my hearing.  I suffered no hearing loss from that surgery on the right, but I now have only 20% hearing on my AN left side.  I experienced some minor balance issues following the MVD surgery so I am now wondering if damage was done to the right vestibular nerve at that time.

I will be thinking about you, as you go through the same fears as I regarding the possibility of residual tumor.

CD

[sgerrard]

I am now wondering if damage was done to the right vestibular nerve at that time.

Hi CD,

The hearing and balance nerves are two branches of the 8th cranial nerve, so it seems to me possible that if they were close to the hearing nerve on the right, they were close to the balance nerve there as well, and it could have gotten tweaked. Balance is sensitive enough that it would not have taken much to throw it off. I can well imagine that if the balance nerves on both sides have now been affected, you could have some "significant balance issues." I hope you are able to adapt.

Residual tumor doesn't necessarily mean growing tumor. Surgery cuts away a lot of the blood supply, etc., so even if a bit is left, there is a good chance it won't grow again. I hope that is the case for you.

And welcome to the forum, too.

Steve

[CHD63]

Steve .....

Thanks for your kind words.  I guess the scary part of this is that on my 5-month-out MRI, the radiologist's interpretation was that it could be scar tissue or residual tumor ..... and I was expecting an "all's clear report" since the surgeon said he had completely removed the tumor.  My surgeon assured me at that time that it was, indeed, a normal MRI for 5 months post-op.  However, now on this one-year-out MRI, the same radiologist is calling it compatible with residual tumor and no mention of scar tissue.  My surgeon is unsure since there are changes from the previous one.

The original AN was a very fast-growing type (did not show on an MRI a year before diagnosis) ..... hence my concern to wait a year now for another MRI.  (Note:  My surgeon feels there is no issue in waiting, judging the comparison of the two post-op MRIs.)

Your comment about cutting away the blood supply makes a lot of sense.

Thanks for your assurance!

Clarice