The development of the microvascular decompression (MVD) operation is revie
wed. It is stressed that a few innovative neurosurgeons discovered the role
of vascular compression of cranial nerves V and VII in trigeminal neuralgi
a (TGN) and hemifacial spasm (HFS) and developed an operation, later to be
known as the MVD operation. While the understanding of the pathophysiology
of these disorders has improved, the surgical procedure has undergone littl
e change since Gardner described the operation about 1960.