Document Detail


Outcome after pituitary radiosurgery for thalamic pain syndrome.
MedLine Citation:
PMID:  17570607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate outcomes after pituitary radiosurgery in patients with post-stroke thalamic pain syndrome. METHODS AND MATERIALS: From 2002 to 2006, 24 patients with thalamic pain syndrome underwent pituitary radiosurgery at Tokyo Women's Medical University and were followed at least 12 months thereafter. The radiosurgical target was defined as the pituitary gland and its connection with the pituitary stalk. The maximum dose varied from 140 to 180 Gy. Mean follow-up after treatment was 35 months (range, 12-48 months). RESULTS: Initial pain reduction, usually within 48 h after radiosurgery, was marked in 17 patients (71%). However, in the majority of cases the pain recurred within 6 months after treatment, and at the time of the last follow-up examination durable pain control was marked in only 5 patients (21%). Ten patients (42%) had treatment-associated side effects. Anterior pituitary abnormalities were marked in 8 cases and required hormonal replacement therapy in 3; transient diabetes insipidus was observed in 2 cases, transient hyponatremia in 1, and clinical deterioration due to increase of the numbness severity despite significant reduction of pain was seen once. CONCLUSIONS: Pituitary radiosurgery for thalamic pain results in a high rate of initial efficacy and is accompanied by acceptable morbidity. It can be used as a primary minimally invasive management option for patients with post-stroke thalamic pain resistant to medical therapy. However, in the majority of cases pain recurrence occurs within 1 year after treatment.
Authors:
Motohiro Hayashi; Mikhail F Chernov; Takaomi Taira; Taku Ochiai; Kotaro Nakaya; Noriko Tamura; Shinichi Goto; Shoji Yomo; Nobuo Kouyama; Yoko Katayama; Yoriko Kawakami; Masahiro Izawa; Yoshihiro Muragaki; Ryoichi Nakamura; Hiroshi Iseki; Tomokatsu Hori; Kintomo Takakura
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-06-14
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  69     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-09-24     Completed Date:  2007-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  852-7     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan. GKRmoto@aol.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Male
Pain, Intractable / surgery*
Pituitary Gland / surgery*
Radiosurgery* / adverse effects
Radiotherapy Dosage
Stroke / complications
Syndrome
Thalamic Diseases / etiology,  surgery*
Treatment Outcome

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


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