Microvascular decompression vs. gamma knife radiosurgery for typical trigeminal neuralgia: preliminary findings.
BACKGROUND
Patients with typical trigeminal neuralgia were treated by one neurosurgeon with either microvascular decompression (MVD) or Gamma Knife radiosurgery (GKRS) and were prospectively evaluated with a uniform protocol.


METHODS
GKRS was done with 75 Gy maximum to the cisternal trigeminal nerve near the pons. MVD was done without cauterizing or cutting the trigeminal nerve.


RESULTS
Twenty-four patients were treated with MVD and 61 with GKRS. Complete pain relief (no pain no medicines) occurred at 12 and 18 months in 68 and 68% of patients treated with MVD and 58 and 24% with GKRS (p = 0.089), and >or=90% pain relief (with or without medicine) at 12 and 18 months in 90 and 78% with MVD and 75 and 48% with GKRS (p = 0.171). There were no permanent complications.


CONCLUSIONS
Although many trigeminal neuralgia patients treated with either MVD or GKRS have pain relief, MVD is more likely than GKRS to result in complete pain relief.
Brisman
Ronald
R
Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA. rb36@columbia.edu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005157:Facial Pain / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*