Document Detail

Gamma knife radiosurgery for primary management for trigeminal neuralgia.
MedLine Citation:
PMID:  11143236     Owner:  NLM     Status:  MEDLINE    
OBJECT: The purpose of this study was to assess the efficacy of gamma knife radiosurgery (GKS) as the primary rather than secondary management for trigeminal neuralgia. METHODS: Eighty-two patients underwent GKS as their first neurosurgical intervention (Group A), and 90 patients underwent GKS following a different procedure (Group B). All GKS patients were treated with a maximum dose of 75 Gy. The single 4-mm isocenter was placed close to the junction of the trigeminal nerve and the brainstem. Six-month follow up was available for 126 patients and 12-month follow up for 84 patients. Excellent (no pain and no medicine) or good (at least 50% reduction in pain and less medicine) relief was more likely to occur in Group A than in Group B patients 6 and 12 months following GKS for trigeminal neuralgia (p = 0.058). Excellent or good results were also more likely in patients with trigeminal neuralgia without multiple sclerosis (MS) (p = 0.042). The number and type of procedures performed prior to GKS, the interval between the last procedure and GKS, and the interval from first symptom to GKS (within Groups A and B) did not affect 6-month outcome. The interval between first symptom and GKS was shorter in Group A patients without MS (87 months) than in Group B (148 months; p < 0.004). There were no significant differences between Group A and B patients with regard to sex, age, or laterality. CONCLUSIONS: Patients with trigeminal neuralgia who are treated with GKS as primary management have better pain relief than those treated with GKS as secondary management. Patients are more likely to have pain relief if they do not have MS.
R Brisman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  93 Suppl 3     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-15     Completed Date:  2001-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-61     Citation Subset:  AIM; IM    
Department of Neurosurgery, Columbia Presbyterian Medical Center, New York, New York, USA.
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MeSH Terms
Brain Stem / surgery*
Follow-Up Studies
Middle Aged
Pain Measurement
Postoperative Complications / diagnosis
Trigeminal Nerve / surgery*
Trigeminal Neuralgia / diagnosis,  surgery*

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