When pain results from an abnormally positioned artery pressing on a cranial nerve, the pain can be relieved by a surgical procedure called vascular decompression. This procedure may be done to treat trigeminal neuralgia, hemifacial spasms, or glossopharyngeal neuralgia.
If the trigeminal nerve is compressed, an area on the back of the head is shaved, and an incision is made. The surgeon cuts a small hole in the skull and lifts the edge of the brain to expose the nerve. Then the surgeon separates the artery from the nerve and places a small sponge between them.
A general anesthetic is required, but the risk of side effects from the procedure is small. Side effects include facial numbness, facial weakness, double vision, infection, bleeding, alterations in hearing and balance, and paralysis.
Usually, this procedure relieves the pain, but in about 15% of people, pain recurs.