Document Detail

Long-term outcome after gamma knife surgery for secondary trigeminal neuralgia.
MedLine Citation:
PMID:  11780888     Owner:  NLM     Status:  MEDLINE    
OBJECT: This study was directed to evaluate the potential role of gamma knife surgery (GKS) in the treatment of secondary trigeminal neuralgia (TN). The authors have identified three anatomicoclinical types of secondary TN requiring different radiosurgical approaches. METHODS: Pain control was retrospectively analyzed in a population of patients harboring tumors of the middle or posterior fossa that involved the trigeminal nerve pathway. This series included 53 patients (39 women and 14 men) treated using GKS between July 1992 and June 1997. The median follow-up period was 55 months. Treatment strategies differed according to lesion type, topography, and size, as well as visibility of the fifth cranial nerve in the prepontine cistern. Three different treatment groups were established. When the primary goal was treatment of the lesion (Group IV, 46 patients) we obtained pain cessation in 79.5% of cases. In some patients in whom GKS was not indicated for treatment of the lesion, TN was treated by targeting the fifth nerve directly in the prepontine cistern if visible (Group II, three patients) or in the part of the lesion including this nerve if the nerve root could not be identified (Group III, four patients). No deaths and no radiosurgically induced adverse effects were observed, but in two cases there was slight hypesthesia (Group IV). The neuropathic component of the facial pain appeared to be poorly sensitive to radiosurgery. At the last follow-up examination, six patients (13.3%) exhibited recurrent pain, which was complete in four cases (8.8%) and partial in two (4.4%). CONCLUSIONS: The results of GKS regarding facial pain control are very similar to those achieved by microsurgery according to series published in the literature. Nevertheless, the low rate of morbidity and the greater comfort afforded the patient render GKS safer and thus more attractive.
J Régis; P Metellus; H Dufour; P H Roche; X Muracciole; W Pellet; F Grisoli; J C Peragut
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  95     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2002-01-08     Completed Date:  2002-01-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-205     Citation Subset:  AIM; IM    
Department of Stereotactic and Functional Neurosurgery, Timone Hospital, Marseilles, France.
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MeSH Terms
Aged, 80 and over
Infratentorial Neoplasms / complications,  physiopathology,  surgery
Middle Aged
Pain Measurement
Retrospective Studies
Time Factors
Treatment Outcome
Trigeminal Nerve / physiopathology
Trigeminal Neuralgia / etiology,  physiopathology,  surgery*

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