Document Detail


Gamma Knife surgery used as primary and repeated treatment for idiopathic trigeminal neuralgia.
MedLine Citation:
PMID:  19123906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The purpose of this study was to assess the outcome of idiopathic trigeminal neuralgia (TN) treated with Gamma Knife surgery (GKS) as a primary and repeated treatment modality with a mean follow-up of 5.7 years. METHODS: Between July 1999 and September 2005, a total of 89 patients with idiopathic TN underwent GKS as a primary treatment. The entry zone of the TN was targeted with a 4-mm collimator and treated with a maximal dose of 60-90 Gy (mean 79 Gy). The dose to the pontine margin was always kept < 15 Gy. Twenty patients received repeated GKS for recurrent or residual pain with a maximal dose of 40-76 Gy (mean 52 Gy). For the second procedure, the target was positioned at the same location as the first treatment. RESULTS: The mean follow-up period was 68 months (range 32-104 months). Sixty-nine (77.5%) of the 89 patients experienced a favorable response, as follows: 50 (56%) had excellent, 12 (13.5%) had good, and 7 (7.8%) had fair outcomes. The mean time to pain relief was 1.1 months (range 2 days-6 months). No significant correlation, but more likely a tendency, was found between the dose and pain relief (p = 0.08). Also, no correlation was noted for facial numbness (p = 0.77). The mean follow-up period after repeated GKS was 60 months (range 32-87 months). Outcomes after repeated GKS were excellent in 11 patients (55%) and good in 1 (5%). Seven patients experienced facial numbness. No correlation was found between the additive dose and pain relief (p = 0.24) or facial numbness (p = 0.15). Final outcomes of primary and repeated GKS were excellent in 61 (68.5%), good in 13 (14.6%), and fair in 7 (7.9%). In total, 91% of the patients were successfully treated with this method. There was no statistical significance for efficacy between primary and repeated GKS (p = 0.65), but there was a significant difference for facial numbness (p = 0.007). CONCLUSIONS: Gamma Knife surgery established durable pain relief when used as a primary and repeated surgery. Treatment was successful for a total of 91% of patients at a mean follow-up of 5.7 years, but facial numbness was also relatively higher.
Authors:
Chuan-Fu Huang; Hsien-Tang Tu; Wen-Shan Liu; Shyh-Ying Chiou; Long-Yau Lin
Related Documents :
15319556 - Long-term outcome after spontaneous cerebellar haemorrhage.
7931586 - Intracranial dural arteriovenous fistulae: angiographic predictors of intracranial hemo...
8347006 - Pulmonary arteriovenous malformations: therapeutic options.
8584826 - Effect of the gamma knife on trigeminal neuralgia.
12474596 - Elbow extension.
25445026 - Choreito formula for bk virus-associated hemorrhagic cystitis after allogeneic hematopo...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  109 Suppl     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-06     Completed Date:  2009-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  179-84     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Chung-Shan Medical University, Taichung, Taiwan. gk@csh.org.tw
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Male
Middle Aged
Radiosurgery*
Recurrence
Retreatment
Retrospective Studies
Rhizotomy
Survival Analysis
Time Factors
Treatment Outcome
Trigeminal Neuralgia / etiology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Clinical outcomes after Gamma Knife surgery for idiopathic trigeminal neuralgia: review of 76 consec...
Next Document:  Comparison of the results of 2 targeting methods in Gamma Knife surgery for trigeminal neuralgia.