Trigeminal neuralgia is called the “world’s first pain”, and its symptoms are very similar to those of toothache, so it is very easy to be confused and misdiagnosed, and is often treated as toothache in dentistry. Trigeminal neuralgia often attacks in the facial areas such as the lips, corners of the mouth, nose, palate or oral mucosa, with recurrent episodes of severe pain. Therefore, when mild symptoms are often mistaken for toothache, patients even blindly go for tooth extraction, thinking that the root of the disease can be removed, which is actually wrong. What is the real cause of trigeminal neuralgia? What are the causes of trigeminal neuralgia? 1, vascular compression, there are 80-90% of primary trigeminal neuralgia trigeminal artery compression. It has also been proposed that because the apex of the internal carotid artery canal is replaced by a thin layer of connective tissue, thus the pulsation of the ventral artery in the semilunar ganglion is in close contact for a long time, generating pressure and triggering trigeminal neuralgia. 2, mechanical compression, some scholars have proposed the trigeminal nerve, trigeminal nerve root is caused by compression of the rocky ridge. It turns out that trigeminal neuralgia in postmenopausal women, which may be due to osteoporosis, bone decalcification, progressive skull base depression. And the skull base is the main factor in the cause of trigeminal neuralgia. 3, ischemia, because trigeminal neuralgia is mostly seen in elderly people over 50 years old, easy to combine with atherosclerosis and cerebral ischemia. Therefore, it has been proposed that the onset of trigeminal neuralgia is due to the trigeminal nerve cells due to repeated ischemia; 4, trigeminal neuralgia may also be caused by injury or viral infection, so the infection theory, there is a decrease in gastric acid, digesting protein in the most patients, producing histamine and histamine substances (such as protein) trigeminal nerve and trigeminal nerve neurogenic edema pain theory. In addition, there are those who believe that trigeminal neuralgia is associated with a familial tendency and has some relationship with heredity. In summary, except for a small percentage due to intracranial tumors, about 80% of patients suffer from compression of the trigeminal nerve root by tortuous intracranial arteries. For patients with trigeminal neuralgia of this etiology, they can be treated with apparent microvascular decompression surgery. The microvascular decompression surgery used by the neurosurgery department of Henan Yellow River Central Hospital is the application of microsurgical techniques to separate the tortuous intracranial compressed vessels from the trigeminal nerve root and separate the vessels from the nerve with some kind of material to achieve the purpose of both preserving the normal sensation of the face and eliminating the pain. At the same time, microvascular decompression is a minimally invasive procedure that does not harm any nerve tissue in the face, preserving the nerve integrity and its functionality.