Linear Accelerator Radiosurgery for Trigeminal Neuralgia

1997 ◽  
pp. 173-182 ◽  
Author(s):  
A.A.F. De Salles ◽  
W. Buxton ◽  
T. Solberg ◽  
P. Medin ◽  
V. Vassilev ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Linear Accelerator

scholarly journals Outcome of radiosurgery treatment with a linear accelerator in patients with trigeminal neuralgia

2017 ◽  
Vol 32 (3) ◽  
pp. 166-174
Author(s):  
N. Cordero Tous ◽  
J. de la Cruz Sabido ◽  
A.M. Román Cutillas ◽  
E.J. Saura Rojas ◽  
A.M. Jorques Infante ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Linear Accelerator

Treatment of trigeminal neuralgia with linear accelerator radiosurgery: initial results

2004 ◽  
pp. 346-350 ◽  
Author(s):  
Joseph C. T. Chen ◽  
Michael Girvigian ◽  
Hugh Greathouse ◽  
Michael Miller ◽  
Javad Rahimian
Keyword(s):  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Linear Accelerator ◽  
Facial Pain ◽  
Recurrent Pain ◽  
Content Type ◽  
Percutaneous Procedures ◽  
Single Isocenter ◽  
Initial Results ◽  
Fine Print

Object. Radiosurgery has emerged as an important treatment of trigeminal neuralgia. Substantial advantages have been demonstrated in safety and comfort over other modalities. Radiosurgical treatment of trigeminal neuralgia has been well investigated with gamma knife devices involving fixed cobalt sources. Few reports exist concerning trigeminal neuralgia treated using linear accelerator (LINAC)—based devices. In recent years these devices have reached the level of mechanical precision that is required for such functional treatments. The authors describe their initial experience with radiosurgical treatment of trigeminal neuralgia when using a BrainLAB Novalis LINAC device equipped with the commercially available 4-mm collimator. Methods. A total of 32 patients were treated in a 12-month period between November 2002 and November 2003. The median patient age was 67 years (range 38–84 years). Facial pain was graded using the Barrow Neurological Institute (BNI) scoring system. All patients' pain was BNI Grade IV or V prior to treatment. Of these patients, 22 were undergoing initial treatment, and 10 were undergoing retreatment for recurrent pain following various treatments including percutaneous procedures, gamma knife surgery (GKS), or microvascular decompression. Two patients had multiple sclerosis. In patients undergoing initial radiosurgery, the most proximal segment of the cisternal portion of the trigeminal nerve received 85 to 90 Gy administered in a 5— or 7—noncoplanar arc single-isocenter plan with a 4-mm circular collimator. In patients undergoing repeated radiosurgery, the target received 60 Gy. Overall good and excellent results (BNI Grade I, II, or III) were achieved in 25 (78%) of 32 patients. The median time to pain relief was 6 weeks. Fair results (improvement in pain with BNI Grade IV) were achieved in three patients (9%), and poor results (no improvement in pain and BNI Grade IV or V) were seen in four (13%). Two patients demonstrated new trigeminal dysfunction following treatment. No other complications occurred. Conclusions. High-precision imaging and LINAC instrumentation have allowed for treatment of trigeminal neuralgia with results and safety comparable to those achieved using GKS. Linear accelerator—based radiosurgery with the Novalis device is a safe and effective method of managing trigeminal neuralgia and may become the preferred means at centers where the technology is available.

Noninvasive linear accelerator radiosurgery as the primary treatment for trigeminal neuralgia

Neurology ◽  
2004 ◽  
Vol 62 (4) ◽  
pp. 660-662 ◽  
Author(s):  
L. Frighetto ◽  
A. A. De Salles ◽  
Z. A. Smith ◽  
B. Goss ◽  
M. Selch ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Linear Accelerator ◽  
Primary Treatment

Linear accelerator radiosurgery comparing 90Gy and less than 90 Gy for essential trigeminal neuralgia

2002 ◽  
Vol 54 (2) ◽  
pp. 145 ◽  
Author(s):  
B Goss ◽  
L Frighetto ◽  
A.A De Salles ◽  
Z Smith ◽  
H Elsaleh ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Linear Accelerator

Outcome for Patients with Essential Trigeminal Neuralgia Treated with Linear Accelerator Stereotactic Radiosurgery

2011 ◽  
Vol 89 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Marcos Antonio dos Santos ◽  
José Bustos Pérez de Salcedo ◽  
José Angel Gutiérrez Diaz ◽  
Gorka Nagore ◽  
Felipe A. Calvo ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Stereotactic Radiosurgery ◽  
Linear Accelerator

Linear Accelerator Radiosurgery for Trigeminal Neuralgia

Neurosurgery ◽  
2005 ◽  
Vol 57 (6) ◽  
pp. 1193-1200 ◽  
Author(s):  
Gregory M. Richards ◽  
Kristin A. Bradley ◽  
Wolfgang A. Tomé ◽  
Søren M. Bentzen ◽  
Daniel K. Resnick ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Linear Accelerator ◽  
Response Duration ◽  
Pain Scale ◽  
Treatment Delivery ◽  
Idiopathic Trigeminal Neuralgia ◽  
Facial Numbness ◽  
Effective Pain Relief ◽  
Mean Time

Abstract OBJECTIVE: To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery. METHODS: Twenty-eight patients with medication refractory idiopathic trigeminal neuralgia were treated with a single fraction of 80 Gy to the trigeminal nerve root. For treatment delivery, a 4-mm collimator and a 7-arc technique were delivered using a stereotactic floor stand system with an isocenter stability of 0.2 ± 0.1 mm to minimize dose to the brainstem. Treatment delivery time was approximately 55 minutes. RESULTS: With a median follow-up of 12 months (range, 1–40 mo), 57% of patients achieved complete pain relief and 75% (exact 95% confidence interval, 55 to 89%) had their pain reduced to 3 or less on a 10-point pain scale. Median time to pain relief was 1 month. Four patients did not respond to treatment. The actuarial mean time to pain recurrence in responders was 14 months, and the actuarial mean response duration in major to complete responders was 16 months. Women had significantly longer mean time to pain recurrence than men (16 versus 7 months; P = 0.05). Three patients reported new mild facial numbness after radiosurgery and one patient developed neurotrophic keratopathy. CONCLUSION: Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.

Linear accelerator–based radiosurgery for trigeminal neuralgia: comparative outcomes of frame-based and mask-based techniques

2021 ◽  
pp. 1-10
Author(s):  
Jenny C. Kienzler ◽  
Stephen Tenn ◽  
Srinivas Chivukula ◽  
Fang-I Chu ◽  
Hiro D. Sparks ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Pain Control ◽  
Linear Accelerator ◽  
Initial Response ◽  
Time To Recurrence ◽  
Facial Numbness ◽  
The Mean

OBJECTIVE Precise and accurate targeting is critical to optimize outcomes after stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). The aim of this study was to compare the outcomes after SRS for TN in which two different techniques were used: mask-based 4-mm cone versus frame-based 5-mm cone. METHODS The authors performed a retrospective review of patients who underwent SRS for TN at their institution between 1996 and 2019. The Barrow Neurological Institute (BNI) pain score and facial hypesthesia scale were used to evaluate pain relief and facial numbness. RESULTS A total of 234 patients were included in this study; the mean age was 67 years. In 97 patients (41.5%) radiation was collimated by a mask-based 4-mm cone, whereas a frame-based 5-mm cone was used in the remaining 137 patients (58.5%). The initial adequate pain control rate (BNI I–III) was 93.4% in the frame-based 5-mm group, compared to 87.6% in the mask-based 4-mm group. This difference between groups lasted, with an adequate pain control rate at ≥ 24 months of 89.9% and 77.8%, respectively. Pain relief was significantly different between groups from initial response until the last follow-up (≥ 24 months, p = 0.02). A new, permanent facial hypesthesia occurred in 30.3% of patients (33.6% in the frame-based 5-mm group vs 25.8% in the mask-based 4-mm group). However, no significant association between the BNI facial hypesthesia score and groups was found. Pain recurrence occurred earlier (median time to recurrence 12 months vs 29 months, p = 0.016) and more frequently (38.1% vs 20.4%, p = 0.003) in the mask-based 4-mm than in the frame-based 5-mm group. CONCLUSIONS Frame-based 5-mm collimator SRS for TN resulted in a better long-term pain relief with similar toxicity profiles to that seen with mask-based 4-mm collimator SRS.

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