‏An elderly woman has been suffering from severe refractory facial pain for 5 years
in trigeminal neuralgia, the trigeminal nerve that is responsible for facial sensation is constantly stimulated by arterial pulsation or sometimes vein pressure
first line treatment is a medication. surgery is mandatory if the pain dose not respond to the drugs

Surgery is done via retrosigmoid approach, nerves and vessels are dissected and a teflone place between the nerve and arte