三叉神经微血管减压术是国际上公认的治疗三叉神经痛的首选治疗方法,其原理是三叉神经根存在血管压迫,可能导致脱髓鞘病变而异常放电。神经影像学可以帮助临床医师区分神经根是被动脉还是静脉压迫,前者的预后要远远好于后者。三叉神经痛复发后往往需要再次手术,术中精细操作,减少三叉神经的损伤能减少复发,在术中要特别注意避免三叉神经-心脏反射的并发症。现对三叉神经微血管减压术的基础原理和治疗细节进行阐述。 Trigeminal nerve microvascular decompression is internationally recognized treatment of trigeminal neuralgia preferred treatment, the principle is the existence of trigeminal nerve root compression, may lead to abnormal demyelination discharge. Neuroimaging can help clinicians to distinguish between nerve root or vein compression, the prognosis of the former is much better than the latter. Trigeminal neuralgia often require reoperation after recurrence, fine operation during surgery to reduce the damage of the trigeminal nerve can reduce the recurrence of intraoperative need to pay special attention to avoid complications of trigeminal nerve - cardiac reflex. Now on the trigeminal nerve microvascular decompression of the basic principles and treatment details are described.