Background: Neurovascular compression syndromes (NVCS) represent a spectrum of disabling neurologic disorders caused by vascular or structural compression of cranial nerves, most commonly at the root entry zone. Conditions such as trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GN) are associated with significant pain, functional impairment, and reduced quality of life. This review provides a multidisciplinary, anatomically grounded overview of the pathophysiology, diagnosis, imaging, and contemporary management strategies for NVCS. Methods: A narrative review of the literature was conducted, synthesizing historical perspectives, neuroanatomy of the cerebellopontine angle, mechanisms of neurovascular conflict, advances in imaging and neuromonitoring, and current treatment modalities. Medical, percutaneous, surgical, radiosurgical, and neuromodulatory approaches were evaluated, with emphasis on patient selection and outcome considerations. Results: Neurovascular compression, most frequently arterial compression at the root entry zone, leads to focal demyelination, ephaptic transmission, and neuronal hyperexcitability. High-resolution Magnetic resonance imagin (MRI) remains the diagnostic gold standard. First-line management for TN and related syndromes typically includes pharmacotherapy, particularly sodium channel blockers. Refractory cases may benefit from percutaneous rhizotomy, balloon compression, stereotactic radiosurgery, or microvascular decompression (MVD), which offers the most durable relief in appropriately selected patients. Emerging technologies, including endoscopic visualization, advanced neuromodulation, and virtual reality-assisted surgical planning, continue to refine treatment precision and safety. Conclusions: Effective management of NVCS requires a comprehensive understanding of neuroanatomy, pathogenesis, and individualized risk-benefit profiles. A multidisciplinary, stepwise approach optimizes outcomes and improves quality of life in patients with these complex disorders.
Abstract
Journal Article
Review
eng
42352577
Reilly, Madelyn, et al. "Neurovascular Compression Syndromes of Cranial Nerves: a Multidisciplinary Guide to Management." Brain Sciences, vol. 16, no. 6, 2026.
Reilly M, Hashimoto N, Chen K, et al. Neurovascular Compression Syndromes of Cranial Nerves: A Multidisciplinary Guide to Management. Brain Sci. 2026;16(6).
Reilly, M., Hashimoto, N., Chen, K., Kaye, A. D., & Abd-Elsayed, A. (2026). Neurovascular Compression Syndromes of Cranial Nerves: A Multidisciplinary Guide to Management. Brain Sciences, 16(6). https://doi.org/10.3390/brainsci16060569
Reilly M, et al. Neurovascular Compression Syndromes of Cranial Nerves: a Multidisciplinary Guide to Management. Brain Sci. 2026 May 28;16(6) PubMed PMID: 42352577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Neurovascular Compression Syndromes of Cranial Nerves: A Multidisciplinary Guide to Management.
AU - Reilly,Madelyn,
AU - Hashimoto,Nina,
AU - Chen,Kalvin,
AU - Kaye,Alan D,
AU - Abd-Elsayed,Alaa,
Y1 - 2026/05/28/
PY - 2026/04/21/received
PY - 2026/05/22/revised
PY - 2026/05/26/accepted
PY - 2026/6/26/medline
PY - 2026/6/26/pubmed
PY - 2026/6/26/entrez
KW - cerebellopontine angle
KW - cranial nerves
KW - glossopharyngeal neuralgia
KW - hemifacial spasm
KW - magnetic resonance imaging
KW - microvascular decompression
KW - neuromodulation
KW - neurovascular compression syndromes
KW - neurovascular conflict
KW - stereotactic radiosurgery
KW - trigeminal neuralgia
JF - Brain sciences
JO - Brain Sci
VL - 16
IS - 6
N2 - Background: Neurovascular compression syndromes (NVCS) represent a spectrum of disabling neurologic disorders caused by vascular or structural compression of cranial nerves, most commonly at the root entry zone. Conditions such as trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GN) are associated with significant pain, functional impairment, and reduced quality of life. This review provides a multidisciplinary, anatomically grounded overview of the pathophysiology, diagnosis, imaging, and contemporary management strategies for NVCS. Methods: A narrative review of the literature was conducted, synthesizing historical perspectives, neuroanatomy of the cerebellopontine angle, mechanisms of neurovascular conflict, advances in imaging and neuromonitoring, and current treatment modalities. Medical, percutaneous, surgical, radiosurgical, and neuromodulatory approaches were evaluated, with emphasis on patient selection and outcome considerations. Results: Neurovascular compression, most frequently arterial compression at the root entry zone, leads to focal demyelination, ephaptic transmission, and neuronal hyperexcitability. High-resolution Magnetic resonance imagin (MRI) remains the diagnostic gold standard. First-line management for TN and related syndromes typically includes pharmacotherapy, particularly sodium channel blockers. Refractory cases may benefit from percutaneous rhizotomy, balloon compression, stereotactic radiosurgery, or microvascular decompression (MVD), which offers the most durable relief in appropriately selected patients. Emerging technologies, including endoscopic visualization, advanced neuromodulation, and virtual reality-assisted surgical planning, continue to refine treatment precision and safety. Conclusions: Effective management of NVCS requires a comprehensive understanding of neuroanatomy, pathogenesis, and individualized risk-benefit profiles. A multidisciplinary, stepwise approach optimizes outcomes and improves quality of life in patients with these complex disorders.
SN - 2076-3425
UR - https://www.unboundmedicine.com/prime/citation/42352577/Neurovascular_Compression_Syndromes_of_Cranial_Nerves:_A_Multidisciplinary_Guide_to_Management.
DB - PRIME
DP - Unbound Medicine
ER -
