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Safety of microvascular decompression for trigeminal neuralgia in the elderly

Clinical article

Anand I. Rughani, Travis M. Dumont, Chih-Ta Lin, Bruce I. Tranmer, and Michael A. Horgan

EVD; reexploration craniotomy 1 65 F iatrogenic CVA or hemorrhage EVD 5 72 F iatrogenic CVA or hemorrhage; brain compression other craniotomy 54 72 F acute myocardial infarction none 3 78 M coma reexploration of craniotomy 4 78 F acute myocardial infarction none 5 82 M ischemic stroke; hydrocephalus EVD 2 89 F hemorrhage complicating procedure EVD 3 * CVA = cerebrovascular accident; EVD = external ventricular drain. Discussion Trigeminal neuralgia is a disabling condition

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The effect of single-application topical ophthalmic anesthesia in patients with trigeminal neuralgia

A randomized double-blind placebo-controlled trial

Douglas Kondziolka, Thomas Lemley, John R. W. Kestle, L. Dade Lunsford, Gerhard H. Fromm, and Peter J. Jannetta

T he management of trigeminal neuralgia has intrigued physicians for several hundred years. Recently, letters to the editor in both the Journal of the American Medical Association 10, 11 and the Journal of Neurosurgery 7 described the long-term value of single-application topical ophthalmic anesthesia (two drops of 0.5% proparacaine hydrochloride) onto the cornea ipsilateral to the trigeminal neuralgia. Reportedly, this observation was made by a physician with trigeminal neuralgia who had a topical anesthetic agent applied to his eye during an

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Repeat microvascular decompression for recurrent idiopathic trigeminal neuralgia

Clinical article

Nicolaas A. Bakker, J. Marc C. Van Dijk, Steven Immenga, Michiel Wagemakers, and Jan D. M. Metzemaekers

I diopathic trigeminal neuralgia (TN) is a disabling disorder characterized by sudden attacks of unilateral facial pain. Microvascular decompression (MVD) is the method of choice to definitively cure the condition if medical treatment fails to provide sufficient relief. Although the success rates of MVD tends to reduce over time, in the majority of patients (up to 70%) long-term relief (10–15 years) can be achieved with minimal morbidity and mortality. 2 , 10 This also implies that a significant proportion of patients suffers recurrent TN after MVD, a

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Gamma knife surgery for trigeminal neuralgia: outcomes and prognostic factors

Jason Sheehan, Hung-Chuan Pan, Matei Stroila, and Ladislau Steiner

following GKS. This result is arguably very meaningful to patients with severe pain and can translate into a significant improvement in the quality of life. The variable history of TN is the other major difficulty in analyzing results from small to medium sized retrospective studies. Trigeminal neuralgia can be characterized by spontaneous partial or complete remissions. Its characteristic waxing and waning as well as the subjectivity of pain, sensory loss, and paresthesias make a longer follow-up period and straightforward end points essential. Prognostic Factors

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Results of a third Gamma Knife radiosurgery for trigeminal neuralgia

Corbin A. Helis, Ryan T. Hughes, Michael T. Munley, J. Daniel Bourland, Travis Jacobson, John T. Lucas Jr., Christina K. Cramer, Stephen B. Tatter, Adrian W. Laxton, and Michael D. Chan

part at the 61st Annual Meeting of the American Society for Radiation Oncology (ASTRO) held in Chicago, IL, on September 15–18, 2019. References 1 Pollock BE . Surgical management of medically refractory trigeminal neuralgia . Curr Neurol Neurosci Rep . 2012 ; 12 ( 2 ): 125 – 131 . 10.1007/s11910-011-0242-7 22183181 2 Kondziolka D , Zorro O , Lobato-Polo J , Gamma Knife stereotactic radiosurgery for idiopathic trigeminal neuralgia

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Microvascular decompression after failed Gamma Knife surgery for trigeminal neuralgia: a safe and effective rescue therapy?

Clinical article

Raymond F. Sekula Jr., Andrew M. Frederickson, Peter J. Jannetta, Sanjay Bhatia, and Matthew R. Quigley

T rigeminal neuralgia is a debilitating facial pain disorder. When medications fail, procedures including percutaneous glycerol rhizotomy, percutaneous radiofrequency rhizotomy, percutaneous balloon compression rhizolysis, stereotactic radiosurgical rhizolysis (GKS), and MVD are available to the patient. Because the safety, efficacy, and durability of MVD for trigeminal neuralgia in the young and elderly have been established, many clinicians view MVD as the first line of treatment when medications fail. 2 , 3 , 21 , 23 , 50 , 51 , 55 , 58 In the past 2

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Results of repeated gamma knife radiosurgery for medically unresponsive trigeminal neuralgia

Bruce E. Pollock, Robert L. Foote, Scott L. Stafford, Michael J. Link, Deborah A. Gorman, and Paula J. Schomberg

T he treatment of patients with medically unresponsive trigeminal neuralgia with GKS is not new. Leksell 11 performed GKS in 63 patients with trigeminal neuralgia between 1968 and 1982. Imaging quality of the trigeminal nerve or ganglion during this period was poor, however, and the precise radiation dose delivered was unknown. Lindquist, et al., 12 later reported the outcomes for 46 of these patients. Approximately 50% became pain free initially, but the pain recurred in most patients over the next several years. Rand, et al., 15 treated 12 patients with

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Percutaneous retrogasserian glycerol injection in the management of trigeminal neuralgia: long-term follow-up results

Takamitsu Fujimaki, Takanori Fukushima, and Shinichiro Miyazaki

S ince its introduction by Håkanson 8 in 1981, percutaneous retrogasserian glycerol injection has become an increasingly popular form of therapy for trigeminal neuralgia. 1, 2, 4, 11, 13, 16–18, 20, 22, 26 Several authors have reported that this procedure avoids sensory loss and dysesthesia. 8, 13, 26 The role of percutaneous retrogasserian glycerol injection in the treatment of trigeminal neuralgia is, however, still controversial because of the pain recurrence and significant sensory deficit associated with it. 2, 3, 16, 21, 22 This report analyzes our

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Pathophysiology of trigeminal neuralgia: new evidence from a trigeminal ganglion intraoperative microneurographic recording

Case report

Kim J. Burchiel and Thomas K. Baumann

. Baumann TK , Burchiel KJ : A method for intraoperative microneurographic recording of unitary activity in the trigeminal ganglion of patients with trigeminal neuralgia. J Neurosci Methods 132 : 19 – 24 , 2004 Baumann TK, Burchiel KJ: A method for intraoperative microneurographic recording of unitary activity in the trigeminal ganglion of patients with trigeminal neuralgia. J Neurosci Methods 132: 19–24, 2004 2. Devor M , Amir R , Rappaport ZH : Pathophysiology of trigeminal neuralgia: the ignition hypothesis

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Preoperative visualization of neurovascular anatomy in trigeminal neuralgia

Jonathan Miller, Feridun Acar, Bronwyn Hamilton, and Kim Burchiel

like to express our appreciation and thanks to Shirley McCartney, Ph.D., and Andy Rekito, M.S., for contributions to this manuscript, and to Valerie Anderson, Ph.D., for electronic institutional review board assistance. References 1 Akimoto H , Nagaoka T , Nariai T , Takada Y , Ohno K , Yoshino N : Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging . Neurosurgery 51 : 956 – 962 , 2002 2 Anderson