Gamma Knife Radiosurgery for Trigeminal Neuralgia

Kondziolka, Douglas; Perez, Bernardo; Flíckinger, John C.; Habeck, Michael; Lunsford, L. Dade

doi:10.1001/archneur.55.12.1524

Cited by 194 publications

(125 citation statements)

References 25 publications

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“…16 The initial response rates in our patients are comparable to those reported in the majority of previous studies of GKS. [4][5][6][12][13][14][15][30][31][32] The effect of the latency period after SRS in our study is comparable with the findings in previously reported series. 8,17,22,23,29,31 Interestingly, patients with previous surgery seem to be more frequently late responders to GKS than patients with no history of previous surgery.…”

Section: Discussionsupporting

confidence: 91%

“…However, other clinical investigators have reported lower incidence rates of posttreatment facial numbness. 10,15,17,23,29 The development of numbness was slightly higher in the group of patients with previous surgery in our study. However, this difference was not statistically significant.…”

Section: Neurosurg Focus / Volume 23 / December 2007contrasting

confidence: 41%

“…8,16 Numerous authors have reported on SRS with the GK, and outcome and complication rates have been variable. [1][2][3][4][5][6]8,[10][11][12][13][14][15][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The observed variation in success rates in the literature may be explained by the subjectivity of assessing pain (which is the most important outcome parameter in these studies), the multifactorial causes of TN (idiopathic or secondary to a pathological entity), the significantly varying stereotactic radiosurgical treatment protocols (different anatomical targets and different radiation doses), and the usage of illdefined and widely variable outcome assessment criteria.…”

Section: Discussionmentioning

confidence: 99%

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Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia: long-term outcome and complications

Fountas¹,

Smith²,

Lee³

et al. 2007

FOC

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Object Stereotactic radiosurgery (SRS) with the Gamma Knife (GK) is a rapidly emerging surgical modality in the management of medically refractory idiopathic trigeminal neuralgia (TN). The current study examines the long-term outcome in patients with drug-resistant idiopathic TN who underwent GK surgery at the authors‘ institution. Methods One hundred and six consecutive patients (38 men and 68 women) with proven medically refractory idiopathic TN were included in this retrospective study. Their ages were 41–82 years (mean 72.3 years). All patients underwent SRS with prescribed maximal radiation doses ranging from 70 to 85 Gy. Isocenters 1–3 were used and plugging was used selectively. The follow-up period was 12–72 months (mean 34.3 months). The patients were divided into 2 groups according to their history of previous surgery. Results The initial response rate in patients with no history of previous surgery was 92.9%; in those who had undergone previous surgery, the initial response rate was 85.7%. At the end of the 1st posttreatment year, an excellent outcome was achieved in 82.5% of patients who had not had previous surgery, and in 69.4% of those who had. The respective outcome rates for the 2nd posttreatment year were 78 and 63.5%, respectively. The most common complication was the development of persistent paresthesia, which occurred in 15.8% of patients with no previous surgery and 16.3% of those with previous surgery. Conclusions Stereotactic radiosurgery with the GK is a safe and effective treatment option for patients with medically refractory idiopathic TN.

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Section: Discussionsupporting

confidence: 91%

Section: Neurosurg Focus / Volume 23 / December 2007contrasting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia: long-term outcome and complications

Fountas¹,

Smith²,

Lee³

et al. 2007

FOC

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“…Furthermore, very small collimators (4-8 mm at isocenter) and high single doses between 100 and 200 Gy were necessary for this kind of treatment [23,28,54]. Treatment of trigeminal neuralgia by radiosurgery has become a common indication in the last few years [31,36,39,42]. This technique can achieve comparable results as more invasive treatment techniques for facial pain (Figure 2).…”

Section: Functional Radiosurgerymentioning

confidence: 99%

Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for neurooncological and neurological diseases: state of the art and future perspectives

Münter

Welker

Jensen

et al. 2013

Innovative Neurosurgery

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Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) are well established in a high number of neurooncological and neurological lesions. Modern technologies discussed in this review, especially the integration of multimodality imaging in the daily clinical routine, will further improve the results of SRS and SRT. Currently, the different technical methods used are comparable regarding the clinical results in different clinical indications. The technological advances allow high treatment flexibility, and therefore, new treatment indications can be established based on the new technologies. In the future, it has to be defined more clearly whether a single fraction, hypofractionated concepts, or fractionated stereotactic radiotherapy is more effective regarding the clinical results and side effects of the therapy. The main area of development for radiosurgery will be stereotactic body radiosurgery. More randomized clinical studies for all possible indications are needed in the next few decades in order to establish radiosurgery more precisely, and also to determine its true value, especially in normal-fractionated radiotherapy. In technological development, the next step has been completed and proton or particle based stereotactic radiosurgery may have increased use in the future.

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“…The Gamma Knife has historically been the "Gold-Standard" for the radiosurgical lesioning of trigeminal neuralgia (TN) [1][2]. By administering 60-90 Gy with a Co-60 source through a 4 mm aperture, the Gamma Knife has been shown to produce conformal isodose distributions and correspondingly excellent clinical results [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%