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Gamma Knife radiosurgery for cluster-tic syndrome unresponsive to medical treatment: illustrative case

Lina R. Barzaghi, Edoardo Pompeo, Luigi Albano, Antonella Del Vecchio, and Pietro Mortini

Cluster-tic syndrome is a rare and disabling disorder characterized by simultaneous and ipsilateral occurrence of cluster headache attacks and trigeminal neuralgia, even though the two components may occur asynchronously. Although cluster-tic syndrome has been described since 1978, 1 it was included in the International Classification of Headache Disorders only in its third edition (ICHD-3). 2 In most cases described in medical literature, there was no obvious underlying structural brain lesion. As stated in the ICHD-3, it is essential to recognize each

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White epidermoid cyst transformation after stereotactic radiosurgery: illustrative case

Hideki Matsumoto, Yuki Shinya, Satoru Miyawaki, Masahiro Shin, Satoshi Koizumi, Daisuke Sato, Munetoshi Hinata, Masako Ikemura, Satoshi Kiyofuji, Taich Kin, Mototaro Iwanaga, Masahiro Shimizu, Hirofumi Nakatomi, and Nobuhito Saito

epidermoid cysts composed of keratin and cholesterol crystals. 2 A case of typical epidermoid cysts transformed into WECs has been reported previously. 3 However, none of those prior reports discussed the potential contribution of radiation. In the present report, we present a case of a WEC transformed from histologically confirmed typical epidermoid cysts 14 years after stereotactic radiosurgery (SRS). Illustrative Case History, Examination, and Imaging A 55-year-old man presented with left trigeminal neuralgia (TN), and radiological examinations revealed a

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Long-term survival in patients with long-segment complex meningiomas occluding the dural venous sinuses: illustrative cases

Zhishuo Wei, Arka N. Mallela, Andrew Faramand, Ajay Niranjan, and L. Dade Lunsford

trigeminal neuralgia (TGN) 24 months after her craniotomy and was treated with SRS for management of her facial pain. She underwent repeat SRS 120 months after the initial craniotomy for recurrent tumor. Repeat trigeminal GK SRS was performed three times for recurrent pain. At 243 months after the initial craniotomy, her tumor and facial pain were stable. B: The radiosurgery dose plan projected on the axial, coronal, and sagittal views for stages 1, 2, and 3 of the first and second SRS. The 214-month follow-up MRI after first GK shows stable tumor. Images obtained 2

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Salvage pemetrexed for brain metastases from ALK-positive lung cancer after Gamma Knife radiosurgery: illustrative case

Ryuichi Noda, Atsuya Akabane, Mariko Kawashima, Masafumi Segawa, Sho Tsunoda, and Tomohiro Inoue

appearing in the pituitary gland ( Fig. 1L and M ). Eventually, trigeminal neuralgia resulted from direct invasion of the cranial nerve ( Fig. 1N ). Brigatinib was replaced with four courses of pemetrexed (150 mg/m 2 ) with carboplatin (320 mg/m 2 ), followed by pemetrexed maintenance (150 mg/m 2 ), based on the association between ALK -positive lung adenocarcinoma and durable responses to pemetrexed. The recurrent tumor and pituitary metastasis showed an immediate response to cytotoxic chemotherapy and were kept under control for the next 17 months ( Fig. 2 ). The