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Geometrical accuracy of the Novalis stereotactic radiosurgery system for trigeminal neuralgia

Javad Rahimian, Joseph C. Chen, Ajay A. Rao, Michael R. Girvigian, Michael J. Miller, and Hugh E. Greathouse

S tereotactic radiosurgery and stereotactic radiotherapy are effectively used in the treatment of arteriovenous malformation, trigeminal neuralgia, and certain brain tumors. Over 50 years ago the first case of trigeminal neuralgia was treated radiosurgically by Lars Leksell. 5 Stereotactic radiosurgery and stereotactic radiotherapy deliver high-dose radiation to a target volume in single and multiple fractions, 4 respectively, while sparing the normal tissues. The procedures involve placement of a stereotactic frame on the patient's skull, localization of

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Gamma Knife surgery for trigeminal neuralgia: a review of 450 consecutive cases

Clinical article

Jeroen B. Verheul, Patrick E. J. Hanssens, Suan Te Lie, Sieger Leenstra, Hendrik Piersma, and Guus N. Beute

, Greece. References 1 Brisman R : Gamma knife radiosurgery for primary management for trigeminal neuralgia . J Neurosurg 93 : 3 Suppl 159 – 161 , 2000 2 Broggi G , Ferroli P , Franzini A , Nazzi V , Farina L , La Mantia L , : Operative findings and outcomes of microvascular decompression for trigeminal neuralgia in 35 patients affected by multiple sclerosis . Neurosurgery 55 : 830 – 839 , 2004 3 Chang JW , Chang JH , Park YG , Chung SS : Gamma knife radiosurgery for idiopathic and secondary trigeminal neuralgia . J

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Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression

Clinical article

Albert Lee, Shirley McCartney, Cole Burbidge, Ahmed M. Raslan, and Kim J. Burchiel

I n 1934 Dandy 12 first proposed that vascular compression of the trigeminal nerve was a cause of trigeminal neuralgia (TN). However, he also pointed out that vascular contact occasionally occurs without the production of TN and that TN may be present in the absence of contact. 12 Compression of the trigeminal nerve by a blood vessel at or near the root entry zone 12 , 14 , 21 is still thought to be the most common cause for TN. Devor's “ignition theory” of TN relies on a focus of hyperactivity in the retrogasserian root, consistent with a focus of

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Retreatment of trigeminal neuralgia with Gamma Knife radiosurgery: is there an appropriate cumulative dose?

Clinical article

Tomas Dvorak, Arkadiy Finn, Lori Lyn Price, John E. Mignano, Markus M. Fitzek, Julian K. Wu, and Kevin C. Yao

Boston, Massachusetts, in September 2008. References 1 Brisman R : Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia . J Neurosurg 100 : 848 – 854 , 2004 2 Brisman R : Repeat gamma knife radiosurgery for trigeminal neuralgia . Stereotact Funct Neurosurg 81 : 43 – 49 , 2003 3 Dutta PR , Kwok Y , Herman JM , Chin LS , Colliver C , St. Clair WH , : Comparison of repeat GK-SRS for refractory or recurrent trigeminal neuralgia: does dose matter? . Int J Radiat Oncol Biol Phys 60 : 1 Suppl S405 , 2004

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Gamma Knife surgery for recurrent or residual trigeminal neuralgia after a failed initial procedure

Clinical article

Chuan-Fu Huang, Shyh-Ying Chiou, Ming-Fang Wu, Hsien-Tang Tu, and Wen-Shan Liu

controlled following an initial procedure. Previous studies on the use of GKS for recurrent pain have referred to results after 1 or multiple prior surgeries, but outcomes are often compared by treating pain recurrence after single and multiple surgeries as being the same condition. We report results for patients who only underwent a single procedure, including GKS as a primary treatment, for residual or recurrent trigeminal neuralgia, and our study also includes a substantially longer follow-up time than other studies. Methods Patient Population Between 1999 and

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Clinical outcomes after Gamma Knife surgery for idiopathic trigeminal neuralgia: review of 76 consecutive cases

Marcos Dellaretti, Nicolas Reyns, Gustavo Touzet, Thierry Sarrazin, François Dubois, Eric Lartigau, and Serge Blond

decompression for trigeminal neuralgia . N Engl J Med 334 : 1077 – 1083 , 1996 10.1056/NEJM199604253341701 2 Brisman R , Mooij R : Gamma Knife radiosurgery for trigeminal neuralgia: dose-volume histograms of the brainstem and trigeminal nerve . J Neurosurg 93 : 3 Suppl 155 – 158 , 2000 10.3171/jns.2000.93.supplement_3.0155 3 Brown JA , Pilitsis JG : Percutaneous balloon compression for the treatment of trigeminal neuralgia: results in 56 patients based on balloon compression pressure monitoring . Neurosurg Focus 18 : 10 – 15 , 2005 4 Fountas KN

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A racial analysis of pain outcomes following microvascular decompression for trigeminal neuralgia

Raymond J. So, Anita L. Kalluri, Kaitlyn Storm, Sumil K. Nair, Bhargavi R. Budihal, Judy Huang, Michael Lim, Chetan Bettegowda, and Risheng Xu

C onsidered one of the most painful conditions afflicting one or more of the dermatomal branches of the fifth cranial nerve, trigeminal neuralgia (TN) is a rare neuropathic disorder with an estimated incidence of 5 new patients per 100,000 people each year. 1 – 3 The etiology of TN is incompletely understood, but vascular compression of the trigeminal nerve has been implicated in more than 75% of cases. 4 – 7 As such, although medical therapies such as carbamazepine and oxcarbazepine are considered first-line treatments, patients with TN refractory to

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A prospective 15-year follow up of 154 consecutive patients with trigeminal neuralgia treated by percutaneous stereotactic radiofrequency thermal rhizotomy

Jamal M. Taha, John M. Tew Jr., and C. Ralph Buncher

S everal studies have reported the results of percutaneous stereotactic radiofrequency rhizotomy (PSR) in the treatment of trigeminal neuralgia. 1, 9, 10 However, at least two issues need further investigation: first, the long-term outcome in patients after PSR and, second, the timing of pain recurrence. The first issue, long-term results of PSR for the treatment of trigeminal neuralgia, has usually been reported in retrospective studies. 1, 8–11 The results of these studies have an inherent bias because information obtained from patient medical records may

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Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia

Ronald Brisman

responses (such as 3, 4, or 5), the average number was recorded. TABLE 2 Trigeminal Neuralgia Questionnaire Please circle the appropriate number for each of the following items based on your situation now and during the past 7 days. A score of 0 means there is no problem or interference with normal function. A score of 10 means a very severe problem. 1) Are you having tic pain (brief bursts of electric-like face pain)? 0 1,2 3,4,5 6,7,8 9,10 None Mild Mild but Moderately Excruciating

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Repeat Gamma Knife surgery for recurrent trigeminal neuralgia: long-term outcomes and systematic review

Clinical article

Constantin Tuleasca, Romain Carron, Noémie Resseguier, Anne Donnet, Philippe Roussel, Jean Gaudart, Marc Levivier, and Jean Régis

G amma Knife surgery (GKS) is a noninvasive procedure, increasingly used in many intracranial conditions, including trigeminal neuralgia (TN). Leksell, the inventor of GKS, performed the first radiosurgical treatment in 1951. 35 , 36 In 1981, Håkanson discovered that the glycerol injection, made for GKS targeting purposes, could also be used as a therapy in TN. 20 , 21 In 1985, once MR imaging was available for clinical use on a large scale, modern dose planning was implemented. 37 In 1993, Rand et al. 45 , 46 advocated that the ganglion was not a good