Skip to main content
SpringerLink
Log in

Stereotactic Radiosurgery for Trigeminal Neuralgia

  • Chapter
  • First Online:
Trigeminal Neuralgia

  • 490 Accesses

Abstract

Stereotactic radiosurgery (SRS) is frequently used to treat medically intractable trigeminal neuralgia (TN), especially when microvascular decompression is not possible, or surgery is not wanted. Freedom of pain can be achieved in about 50% of patients and upto 67.7% of patients lasted treatment effect for 10 years without additional treatment. Higher dose resulted in better pain control, however more than 90Gy of radiation was related to higher complication rates. And complication rates were also related to the radiation affected to the brainstem. There are many considerations for target selection but still there are no definite consensus made.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124(Pt 12):2347–60.

    Article  CAS  PubMed  Google Scholar 

  2. Tuleasca C, et al. Stereotactic radiosurgery for trigeminal neuralgia: a systematic review. J Neurosurg. 2018;130(3):733–57.

    Article  PubMed  Google Scholar 

  3. Marchetti M, et al. Radiosurgery for trigeminal neuralgia: the state of art. Neurol Sci. 2019;40(Suppl 1):153–7.

    Article  PubMed  Google Scholar 

  4. Hodaie M, et al. Tractography delineates microstructural changes in the trigeminal nerve after focal radiosurgery for trigeminal neuralgia. PLoS One. 2012;7(3):e32745.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102(4):316–9.

    CAS  PubMed  Google Scholar 

  6. Leksell L. Sterotaxic radiosurgery in trigeminal neuralgia. Acta Chir Scand. 1971;137(4):311–4.

    CAS  PubMed  Google Scholar 

  7. Rogers CL, et al. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow neurological institute. Int J Radiat Oncol Biol Phys. 2000;47(4):1013–9.

    Article  CAS  PubMed  Google Scholar 

  8. Little AS, et al. Long-term pain response and quality of life in patients with typical trigeminal neuralgia treated with gamma knife stereotactic radiosurgery. Neurosurgery. 2008;63(5):915–23. discussion 923–4

    Article  PubMed  Google Scholar 

  9. Dhople AA, et al. Long-term outcomes of gamma knife radiosurgery for classic trigeminal neuralgia: implications of treatment and critical review of the literature. J Neurosurg. 2009;111(2):351–8.

    Article  PubMed  Google Scholar 

  10. Regis J, et al. Long-term safety and efficacy of gamma knife surgery in classical trigeminal neuralgia: a 497-patient historical cohort study. J Neurosurg. 2016;124(4):1079–87.

    Article  PubMed  Google Scholar 

  11. Mousavi SH, et al. Early radiosurgery provides superior pain relief for trigeminal neuralgia patients. Neurology. 2015;85(24):2159–65.

    Article  PubMed  Google Scholar 

  12. Kondziolka D, et al. Gamma knife stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg. 2010;112(4):758–65.

    Article  PubMed  Google Scholar 

  13. Smith ZA, et al. Dedicated linear accelerator radiosurgery for the treatment of trigeminal neuralgia. J Neurosurg. 2003;99(3):511–6.

    Article  PubMed  Google Scholar 

  14. Richards GM, et al. Linear accelerator radiosurgery for trigeminal neuralgia. Neurosurgery. 2005;57(6):1193–200. discussion 1193–200

    Article  PubMed  Google Scholar 

  15. Lim M, et al. CyberKnife radiosurgery for idiopathic trigeminal neuralgia. Neurosurg Focus. 2005;18(5):E9.

    Article  PubMed  Google Scholar 

  16. Villavicencio AT, et al. Cyberknife radiosurgery for trigeminal neuralgia treatment: a preliminary multicenter experience. Neurosurgery. 2008;62(3):647–55. discussion 647–55

    Article  PubMed  Google Scholar 

  17. Park SH, et al. The retrogasserian zone versus dorsal root entry zone: comparison of two targeting techniques of gamma knife radiosurgery for trigeminal neuralgia. Acta Neurochir. 2010;152(7):1165–70.

    Article  PubMed  Google Scholar 

  18. Xu Z, et al. Impact of target location on the response of trigeminal neuralgia to stereotactic radiosurgery. J Neurosurg. 2014;120(3):716–24.

    Article  PubMed  Google Scholar 

  19. Lim M, et al. Stereotactic radiosurgery using CT cisternography and non-isocentric planning for the treatment of trigeminal neuralgia. Comput Aided Surg. 2006;11(1):11–20.

    Article  PubMed  Google Scholar 

  20. Longhi M, et al. Gamma knife radiosurgery for trigeminal neuralgia: results and potentially predictive parameters--part I: Idiopathic trigeminal neuralgia. Neurosurgery. 2007;61(6):1254–60. discussion 1260–1

    Article  PubMed  Google Scholar 

  21. Matsuda S, et al. Gamma knife radiosurgery for trigeminal neuralgia: the dry-eye complication. J Neurosurg. 2002;97(5 Suppl):525–8.

    Article  PubMed  Google Scholar 

  22. Marshall K, et al. Predictive variables for the successful treatment of trigeminal neuralgia with gamma knife radiosurgery. Neurosurgery. 2012;70(3):566–72. discussion 572–3

    Article  PubMed  Google Scholar 

  23. Barzaghi LR, et al. Gamma knife radiosurgery for trigeminal neuralgia: role of trigeminal length and pontotrigeminal angle on target definition and on clinical effects. World Neurosurg. 2020;142:e140–50.

    Article  PubMed  Google Scholar 

  24. Hung YC, et al. Radiosurgery target location and individual anatomical variation in trigeminal nerves. J Neurosurg. 2014;121(Suppl):203–9.

    Article  PubMed  Google Scholar 

  25. Flickinger JC, et al. Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? A prospective double-blind, randomized study. Int J Radiat Oncol Biol Phys. 2001;51(2):449–54.

    Article  CAS  PubMed  Google Scholar 

  26. Massager N, et al. Gamma knife surgery for idiopathic trigeminal neuralgia performed using a far-anterior cisternal target and a high dose of radiation. J Neurosurg. 2004;100(4):597–605.

    Article  PubMed  Google Scholar 

  27. Massager N, et al. Influence of nerve radiation dose in the incidence of trigeminal dysfunction after trigeminal neuralgia radiosurgery. Neurosurgery. 2007;60(4):681–7. discussion 687–8

    Article  PubMed  Google Scholar 

  28. Mousavi SH, et al. A proposed plan for personalized radiosurgery in patients with trigeminal neuralgia. J Neurosurg. 2018;128(2):452–9.

    Article  PubMed  Google Scholar 

  29. Wolf A, et al. The relationship of dose to nerve volume in predicting pain recurrence after stereotactic radiosurgery in trigeminal neuralgia. J Neurosurg. 2018;128(3):891–6.

    Article  PubMed  Google Scholar 

  30. Omar NB, et al. Repeat gamma knife stereotactic radiosurgery in the treatment of trigeminal neuralgia: a single-center experience and focused review of the literature. J Clin Neurosci. 2019;70:102–7.

    Article  CAS  PubMed  Google Scholar 

  31. Helis CA, et al. Results of a third gamma knife radiosurgery for trigeminal neuralgia. J Neurosurg. 2020;134(3):1237–43.

    PubMed  Google Scholar 

  32. Dellaretti M, et al. Clinical outcomes after gamma knife surgery for idiopathic trigeminal neuralgia: review of 76 consecutive cases. J Neurosurg. 2008;109(Suppl):173–8.

    Article  PubMed  Google Scholar 

  33. Lucas JT Jr, et al. Predictive nomogram for the durability of pain relief from gamma knife radiation surgery in the treatment of trigeminal neuralgia. Int J Radiat Oncol Biol Phys. 2014;89(1):120–6.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Rand RW, et al. Leksell gamma knife treatment of tic douloureux. Stereotact Funct Neurosurg. 1993;61(Suppl 1):93–102.

    Article  PubMed  Google Scholar 

  35. Regis J, et al. Prospective controlled trial of gamma knife surgery for essential trigeminal neuralgia. J Neurosurg. 2006;104(6):913–24.

    Article  PubMed  Google Scholar 

  36. Regis J, et al. The very long-term outcome of radiosurgery for classical trigeminal neuralgia. Stereotact Funct Neurosurg. 2016;94(1):24–32.

    Article  PubMed  Google Scholar 

  37. Tuleasca C, et al. Patterns of pain-free response in 497 cases of classic trigeminal neuralgia treated with gamma knife surgery and followed up for least 1 year. J Neurosurg. 2012;117(Suppl):181–8.

    Article  PubMed  Google Scholar 

  38. Matsuda S, et al. Comparison of the results of 2 targeting methods in gamma knife surgery for trigeminal neuralgia. J Neurosurg. 2008;109(Suppl):185–9.

    Article  PubMed  Google Scholar 

  39. Pollock BE, et al. Stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg. 2002;97(2):347–53.

    Article  PubMed  Google Scholar 

  40. Alpert TE, et al. Gamma knife surgery for trigeminal neuralgia: improved initial response with two isocenters and increasing dose. J Neurosurg. 2005;102(Suppl):185–8.

    Article  PubMed  Google Scholar 

  41. Massager N, et al. Effect of beam channel plugging on the outcome of gamma knife radiosurgery for trigeminal neuralgia. Int J Radiat Oncol Biol Phys. 2006;65(4):1200–5.

    Article  PubMed  Google Scholar 

  42. Kondziolka D, et al. Trigeminal neuralgia radiosurgery: the University of Pittsburgh experience. Stereotact Funct Neurosurg. 1996;66(Suppl 1):343–8.

    Article  PubMed  Google Scholar 

  43. Shaya M, et al. Gamma knife radiosurgery for trigeminal neuralgia: a study of predictors of success, efficacy, safety, and outcome at LSUHSC. Surg Neurol. 2004;61(6):529–34. discussion 534–5

    Article  PubMed  Google Scholar 

  44. Kim YH, et al. Is it effective to raise the irradiation dose from 80 to 85 Gy in gamma knife radiosurgery for trigeminal neuralgia? Stereotact Funct Neurosurg. 2010;88(3):169–76.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea

    Kyung Rae Cho

Authors
  1. Kyung Rae Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea (Republic of)

    Kwan Park

  2. Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea (Republic of)

    Kyung Rae Cho

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cho, K.R. (2023). Stereotactic Radiosurgery for Trigeminal Neuralgia. In: Park, K., Cho, K.R. (eds) Trigeminal Neuralgia. Springer, Singapore. https://doi.org/10.1007/978-981-19-9171-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-9171-4_21

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-9170-7

  • Online ISBN: 978-981-19-9171-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation