Unfortunately, the relief provided by medical therapy generally decreases over time and many patients must stop taking their medications due to side effects, including imbalance, cognitive dysfunction, and hyponatremia. Drug intolerance is particularly prevalent in elderly patients with TN. A variety of operations have been used in the treatment of patients with medically intractable TN: MVD,2,3,8 radiofrequency rhizotomy,15,30 glycerol rhizotomy,24,32 and balloon compression.6,7 Aside from MVD, the remaining operations purposefully damage the trigeminal system and are therefore associated with various degrees of postoperative sensory loss. As an alternative to open surgical procedures, in 1951 Lars Leksell20 performed radiosurgery in a patient with TN by using a modified orthovoltage x-ray tube. Recently, there has been renewed interest in this technique for the treatment of patients with medically unresponsive TN.18,34 In this study, we reviewed our initial 4-year experience with radiosurgery in the treatment of TN.
Jannetta PJ: Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26 (Suppl):159–1621967Jannetta PJ: Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26 (Suppl):