Trigeminal Nerve-Blood Vessel Relationship as Revealed by High-resolution Magnetic Resonance Imaging and Its Effect on Pain Relief after Gamma Knife Radiosurgery for Trigeminal Neuralgia

Abstract

In patients who have not undergone previous surgery for TN, BV-CN V contact revealed by high-resolution magnetic resonance imaging may indicate a particularly favorable response to GKRS.

Repeat Gamma Knife Radiosurgery for Trigeminal Neuralgia

“…All received a maximum dose of 75 Gy to the cisternal trigeminal nerve with usually the 40-50% isodose line tangential to the pontine surface [2]. 45 patients with recurrent or persistent TN were treated with a maximum dose of 40 Gy at GK2 and were available for at least 6 months of follow-up.…”

“…Although gamma knife radiosurgery (GKRS) has been shown to be safe and effective for the treatment of trigeminal neuralgia (TN) [1][2][3][4][5][6], there are only a few studies with small numbers of patients that report the results of a second GKRS [7][8][9]. Patients within each study were often treated with varying protocols.…”

Cost-effectiveness analysis for trigeminal neuralgia: Cyberknife vs microvascular decompression

“…Even though MVD represents the fi rst choice for those patients (Fujimaki et al 1990;Lee et al 1997;Apfelbaum et al 2000), less invasive procedures such as radiofrequency rhizotomy (Taha et al 1995;Kanpolat et al 2001;Tronnier et al 2001), glycerol rhizotomy (Lundsford et al 1984;Saini 1987;Burchiel 1988;Young 1988;North et al 1990), balloon compression (Brown et al 1993;Skirving et al 2001) and gamma knife stereotactic radio surgery (Kondziolka et al 1996;Rogers et al 2000;Maesawa et al 2001;Pollok et al 2002;Brisman et al 2002) are preferred for elderly patients suffering from signifi cant comorbidities, or with recurrent facial pain after prior surgery (Pollock et al 2005).…”

Determination of a Clinical Value for the Repair Half-Time (T1/2) of the Trigeminal Nerve Based on Outcome Data from Gamma Knife Radiosurgery for Facial Pain

“…Idiopathic trigeminal neuralgia (TN), also known as tic douloureux, is characterized by paroxysmal, shock-like pain in one or more of the three trigeminal nerve distributions (1). The underlying patho-physiology is usually neural compression by an adjacent artery or, less commonly, a vein (2). Root entry zone pathology may be critical to the development of the idiopathic syndrome.…”

“…A number of radiosurgery treatment-related factors have been evaluated to determine their influence on clinical outcomes. These include radiation dose, length of irradiated nerve, proximity of the isocenter to the brainstem, and the trigeminal nerveblood vessel relationship (2,(9)(10)(11)(12). Escalating the treatment dose or treating a longer section of the nerve results in a significantly higher rate of permanent trigeminal nerve dysfunction and no significant increase in duration of pain relief (9, 12).…”