Functional neurosurgery with the Leksell Gamma knife.
Sixty patients underwent a total of 64 separate Gamma Knife radiosurgical procedures for treatment of a variety of functional disorders between July 1992 and February 1995. Thirty-four patients with intractable pain received unilateral (32 patients) or bilateral (2 patients) lesions in the intralaminar thalamus. Twenty-nine patients with facial pain, including 19 with typical trigeminal neuralgia. 8 with facial pain due to tumors involving the trigeminal nerve and 2 with other forms of facial pain, were also treated. Five patients with Parkinson's disease underwent pallidotomy (2) or thalamotomy (3) with the Gamma Knife and 2 patients with non-Parkinson's tremor were also treated with gamma-thalamotomy. The rate of improvement or resolution of the functional disorders was similar to that seen with other forms of surgical therapy. No immediate complications were seen, but 4 patients who underwent thalamotomy for pain developed delayed transient complications and 1 death was seen following bilateral thalamotomy.
Young
R F
RF
Northwest Hospital Gamma Knife Center, Seattle, Wash., USA.
D000368:Aged; D003390:Cranial Nerve Neoplasms / Q000150:complications; D005157:Facial Pain / Q000209:etiology / Q000601:surgery*; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009493:Neurosurgery / Q000379:methods*; D010148:Intractable Pain / Q000175:diagnosis / Q000601:surgery*; D010300:Parkinson Disease / Q000601:surgery*; D016634:Radiosurgery; D013788:Thalamus / Q000601:surgery; D016896:Treatment Outcome; D014202:Tremor / Q000601:surgery*; D014276:Trigeminal Nerve