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- W4240438606 abstract "INTRODUCTION: Microvascular decompression has historically been the treatment for medical refractory trigeminal neuralgia (TGN). More recently, gamma knife surgery has been used as an alternative, minimally invasive treatment in TGN. We evaluated the long-term results of gamma knife surgery for the treatment of TGN. METHODS: From 1996 to 2003, we treated 146 cases of TGN with gamma knife surgery. The median patient age was 66 years, and the median time from diagnosis to gamma knife surgery was 72 months. The median follow-up was 18 months. Clinical outcomes and postradiosurgical magnetic resonance imaging studies were analyzed in a statistical fashion. RESULTS: The mean time to relief of pain was 24 days. Twenty-eight percent of patients achieved excellent results, 14.4% good results, 39.8% fair results, and 17.8% poor results. The percentage of patients who were pain-free at 1, 2, and 3 years of follow-up was 48%, 46%, and 39%, respectively. The percentage of patients who experienced some degree of improvement in their pain was 90%, 77%, and 70% at 1, 2, and 3 years of follow-up, respectively. Thirty-three of 118 patients (25%) with initial improvement later experienced recurrence at a median time of 12 months. Eleven patients (8%) developed the onset of facial numbness after radiosurgery. Postradiosurgical magnetic resonance imaging changes were noted in 9 patients (7%). In univariate analysis, right-sided neuralgia (P = 0.0002) and a previous neurectomy (P = 0.04) correlated with a pain-free outcome; in multivariate analysis, right-sided neuralgia (P = 0.032) and age (P = 0.05) were statistically significant. New onset of facial numbness after gamma knife surgery correlated with more than one gamma knife surgery (P = 0.028) and a previous glycerol injection (P = 0.018). CONCLUSION: Gamma knife surgery effectuated pain relief in 39% and pain improvement in 70% of patients with TGN. Although less effective than microvascular decompression, radiosurgery remains a reasonable treatment option for those unwilling or unable to undergo more invasive surgical approaches and offers a low risk of side effects." @default.
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- W4240438606 date "2004-08-01" @default.
- W4240438606 modified "2023-09-25" @default.
- W4240438606 title "751 The Long-term Results of Trigeminal Neuralgia Treated with Gamma Knife Surgery" @default.
- W4240438606 doi "https://doi.org/10.1227/00006123-200408000-00087" @default.
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