Microvascular decompression refers to the surgical microscopic removal of the blood vessels located in the root of the trigeminal nerve, facial nerve and other cranial nerves that are abnormal and cause compression on the cranial nerves, thus relieving the clinical symptoms. Microvascular decompression is now the treatment of choice for trigeminal neuralgia, facial spasm and glossopharyngeal neuralgia where drug therapy is ineffective. The transition zone between the central and unmyelinated peripheral nerves is where the brain nerve enters or emanates from the brainstem and is most vulnerable to damage. When a pulsating artery crosses this area, it can cause degeneration or hyperplasia of the myelin sheath, resulting in a “short circuit” between adjacent nerve fibers and clinical symptoms such as nerve pain and muscle twitching. Arteriosclerosis can aggravate the degree of nerve compression, while arteriosclerotic swelling is more likely to cause elongation and collaterals to compress nerves. In addition, the brainstem shifts downward with age, making the nerve roots vulnerable to vascular compression. Trigeminal neuralgia, also known as “face pain”, is a kind of recurrent paroxysmal severe neuralgia in the distribution area of the facial trigeminal nerve, which is one of the common diseases in neurosurgery and one of the internationally recognized difficult diseases. Most trigeminal neuralgia starts at the age of 40, mostly in middle-aged and elderly people, especially in women, and its onset is more on the right side than on the left side. The disease is characterized by sudden onset, stopping, lightning-like, cutting, burning, intractable and severe pain in the trigeminal nerve distribution area of the head and face. Patients with trigeminal neuralgia often do not dare to wipe their faces, eat, or even swallow saliva, thus affecting their normal life and work. Some people call this pain “the first pain in the world”. Facial muscle spasm, also known as facial muscle twitching, refers to the involuntary jerking of one side of the facial muscles. The spasms are intermittent at the beginning, but gradually become more frequent. Emotional stress and fatigue can aggravate the symptoms and affect work, study and life. Glossopharyngeal neuralgia: It is a paroxysmal pain in the posterior part of the tongue and throat of the distribution area of the glossopharyngeal nerve that can radiate to the external ear. The pain is sudden, located in the posterior root of the tongue, tonsils, and throat, with severe pain like cutting or burning, and can be radiated to the anterior and posterior regions of the external ear or the neck, lasting for several seconds, with intermittent attacks; there can be pain “trigger points” in the root of the tongue, tonsil fossa, and throat, often triggered by eating, swallowing, talking, etc.; occasionally, the pain attack is accompanied by cardiac arrest, fainting, convulsions, etc. Vertigo and tinnitus: partly due to vascular compression of the vestibular and intermediate nerves; partly due to vascular compression of the medullary blood pressure center; partly due to vascular compression of the paraneoplastic nerves.