title: Clinical outcomes after Gamma Knife surgery for idiopathic trigeminal neuralgia: review of 76 consecutive cases.
abstract: OBJECTIVE
  Stereotactic radiosurgery is an increasingly used, and the least invasive, surgical option for patients with trigeminal neuralgia (TN). In this study, the authors performed a retrospective evaluation of the safety and efficacy of this method for idiopathic TN.
  
  
  METHODS
  The authors reviewed data from 76 patients with idiopathic TN who underwent Gamma Knife surgery (GKS). The mean age of the patients was 64 years (range 27-83 years). All patients had typical features of TN. Thirty patients (39.5%) had previously undergone surgery. The intervention consisted of GKS on the retrogasserian cisternal portion of the fifth cranial nerve. The mean maximum GKS dose used was 85.1 Gy (range 75-90 Gy).
  
  
  RESULTS
  Patients were followed-up from 6 to 42 months (mean 20.3 months) after GKS. Complete pain relief was achieved in 83.1% of the patients within 1 year, 70.9% within 2 years, and 62.5% within 3 years. Patients who underwent previous surgery demonstrated a lower rate of pain relief (p < 0.05). Twenty patients (26.3%) reported pain recurrence between 6 and 42 months after treatment. New or worsened persistent trigeminal dysfunction developed after GKS in 16 patients (21%); 8 of these patients described some facial numbness/not bothersome, and 8 reported some facial numbness/somewhat bothersome. None of the patients developed troublesome dysesthesia or anesthesia dolorosa.
  
  
  CONCLUSIONS
  Gamma Knife surgery for idiopathic TN proved to be safe and effective and was associated with a particularly low rate of complications.
authors.affiliation: Department of Neurosurgery, Santa Casa Hospital, Belo Horizonte, Brazil. mdellaretti@mac.com
authors.forename: Marcos
authors.initials: M
authors.lastname: Dellaretti
authors.forename: Nicolas
authors.initials: N
authors.lastname: Reyns
authors.forename: Gustavo
authors.initials: G
authors.lastname: Touzet
authors.forename: Thierry
authors.initials: T
authors.lastname: Sarrazin
authors.forename: François
authors.initials: F
authors.lastname: Dubois
authors.forename: Eric
authors.initials: E
authors.lastname: Lartigau
authors.forename: Serge
authors.initials: S
authors.lastname: Blond
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016634:Radiosurgery; D012189:Retrospective Studies; D019051:Rhizotomy; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000473:pathology / Q000601:surgery*