Trigeminal neuralgia related to megadolichobasilar artery compression: a prospective series of twenty-nine patients treated with gamma knife surgery, with more than one year of follow-up.
Abstract : BACKGROUND:
Trigeminal neuralgia (TN) secondary to megadolichobasilar artery (MBA) compression is considerably difficult to manage surgically.
OBJECTIVE:
This study aims to evaluate the safety/efficacy of Gamma Knife surgery (GKS) in this special group of patients.
METHODS:
Between July 1992 and November 2010, 29 patients with >1 year of follow-up presenting with MBA compression were treated with GKS at Timone University Hospital. Radiosurgery was performed using a Gamma Knife (model B, C or Perfexion). A single 4-mm isocenter was positioned in the cisternal portion of the trigeminal nerve at a median distance of 9.1 mm (range: 6-18.2 mm) from the emergence.
RESULTS:
The median follow-up period was 46.1 months (range: 12.9-157.9 months). Initially, all patients (100%) were pain free; the average time to complete pain relief was 13.5 days (range: 0-240 days). Their actuarial probability of remaining pain free without medication at 0.5, 1 and 2 years was 93.1, 79.3 and 75.7%, respectively, and remained stable until 13 years after treatment. The actuarial probability of hypoesthesia onset at 6 months was 4.3%; at 1 year it reached 13% and remained stable until 13 years after treatment.
CONCLUSIONS:
GKS proved to be reasonably safe and effective on a long-term basis as a first- and/or second-line surgical treatment for TN due to MBA compression.
https://hal-amu.archives-ouvertes.fr/hal-01307484
Contributor : Jean Gaudart
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Submitted on : Tuesday, April 26, 2016 - 5:56:41 PM
Last modification on : Thursday, July 11, 2019 - 2:40:09 PM
Long-term archiving on: Tuesday, November 15, 2016 - 1:33:36 PM
Constantin Tuleasca, Romain Carron, Noémie Resseguier, Anne Donnet, P Roussel, et al.. Trigeminal neuralgia related to megadolichobasilar artery compression: a prospective series of twenty-nine patients treated with gamma knife surgery, with more than one year of follow-up.. Stereotactic and Functional Neurosurgery, Karger, 2014, ⟨10.1159/000362172⟩. ⟨hal-01307484⟩
