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.


Autoria(s): Tuleasca C.; Carron R.; Resseguier N.; Donnet A.; Roussel P.; Gaudart J.; Levivier M.; Régis J.
Data(s)

2014

Resumo

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.

Identificador

https://serval.unil.ch/?id=serval:BIB_CE7B0FB696D6

isbn:1423-0372 (Electronic)

pmid:24943284

doi:10.1159/000362172

isiid:000338411800006

Idioma(s)

en

Fonte

Stereotactic and Functional Neurosurgery, vol. 92, no. 3, pp. 170-177

Palavras-Chave #Aged; Aged, 80 and over; Basilar Artery/pathology; Basilar Artery/surgery; Decompression, Surgical/methods; Decompression, Surgical/trends; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Radiosurgery/methods; Radiosurgery/trends; Treatment Outcome; Trigeminal Neuralgia/diagnosis; Trigeminal Neuralgia/etiology
Tipo

info:eu-repo/semantics/article

article