Repeat Gamma Knife surgery for trigeminal neuralgia: long-term results.


OBJECT:The purpose of this study was to assess the long-term outcome achieved after repeat Gamma Knife surgery (GKS) for trigeminal neuralgia (TN) using a uniform treatment plan. METHODS:Between 1985 and 2010, 53 patients underwent repeat GKS for refractory TN. In the initial GKS, which involved targeting the root entry zone of the trigeminal nerve, a maximal dose of 80 Gy was used with a 4-mm collimator so that the 50% isodose line abutted the pons. In the second GKS, the treatment plan consisted of a 70-Gy dose directed at a target 4-5 mm distal to the first target on the trigeminal nerve. The mean follow-up duration in these patients was 42 months. Outcomes were defined using the Marseille scale: excellent (Class I or II, no pain with or without medications), good (Class III or IV, ≥ 50% relief), and poor (Class V, < 50% relief). RESULTS:Trigeminal neuralgia pain was controlled (≥ 50% improvement with or without medications) after repeat GKS in 70% of patients at 1 year, 50% at 3 years, 50% at 5 years, and 50% at 10 years, as defined by a Kaplan-Meier analysis. A correlation was found between facial numbness and pain relief (p = 0.047). No difference was found between patients with Type 1 TN and those with Type 2 TN, and there was no correlation between the best relief obtained and long-term durability of relief from pain. Twenty-two patients (47.8%) described their trigeminal dysfunction in the following manner: numbness (45.6%), dry eye (10.9%), taste change (8.7%), or jaw weakness (2.2%). In only 8.7% of cases did the patient experience facial numbness that was regarded as bothersome. CONCLUSIONS:Repeat GKS for TN at the doses used provides substantial long-term relief. Treatment failure occurred up to 28 months after the second GKS. Facial numbness correlated with more durable pain relief after repeat GKS in this series.


J Neurosurg


Journal of neurosurgery


Kimball BY,Sorenson JM,Cunningham D




Has Abstract


2010-12-01 00:00:00










113 Suppl


  • Harvey Cushing's Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus.

    abstract::The search for the origin of the commonly held principle in current neurosurgery regarding the resectability of the anterior one third of the superior sagittal sinus unravels the many fascinating developments that occurred in neurosurgery during the early 20th century. All these occurrences can be traced back to, and ...

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    authors: Shrivastava RK,Segal S,Camins MB,Sen C,Post KD

    更新日期:2003-10-01 00:00:00

  • Magnetic resonance demonstration of vertebral artery dissection. Report of two cases.

    abstract::Vertebral artery dissection may be spontaneous or related to some traumatic event. Diagnosis has usually been made by angiography, an invasive procedure with certain well-known risks. The authors describe the magnetic resonance (MR) appearance (both on conventional spin-echo and on gradient refocused "flow" sequences)...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Quint DJ,Spickler EM

    更新日期:1990-06-01 00:00:00

  • Prognostic role of mitochondrial pyruvate carrier in isocitrate dehydrogenase-mutant glioma.

    abstract::OBJECTIVE Gliomas are one of the most common types of primary brain tumors. Recent studies have supported the importance of key genetic alterations, including isocitrate dehydrogenase (IDH) mutations and 1p19q codeletion, in glioma prognosis. Mutant IDH produces 2-hydroxyglutarate from α-ketoglutarate, a key metabolit...

    journal_title:Journal of neurosurgery

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    authors: Karsy M,Guan J,Huang LE

    更新日期:2018-03-16 00:00:00

  • Pressure-volume index as a function of cerebral perfusion pressure. Part 2: The effects of low cerebral perfusion pressure and autoregulation.

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    pub_type: 杂志文章


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    更新日期:1987-09-01 00:00:00

  • What factors impact the clinical outcome of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor?

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    authors: Fukutome K,Kuga Y,Ohnishi H,Hirabayashi H,Nakase H

    更新日期:2020-05-01 00:00:00

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    更新日期:1983-04-01 00:00:00

  • A frameless stereotaxic integration of computerized tomographic imaging and the operating microscope.

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    pub_type: 杂志文章


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    更新日期:1986-10-01 00:00:00

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    abstract::Of the various anterior surgical approaches to the spine, exposure of the upper two thoracic vertebrae remains the most challenging. An operative approach to this region is described. The major features include resection of a portion of the clavicle and the manubrium sterni. Following resection of the tumor and involv...

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    pub_type: 杂志文章


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    更新日期:1984-10-01 00:00:00

  • Effect of country or continent of treatment on outcome after aneurysmal subarachnoid hemorrhage. Clinical article.

    abstract:OBJECT:Prognostic factors for outcome after aneurysmal subarachnoid hemorrhage (SAH) include the clinical and pathological characteristics of the patient and hemorrhage as well as some aspects of treatment. Because treatment can vary between countries and continents, the authors used a large database of patients with S...

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    pub_type: 杂志文章


    authors: Lipsman N,Tolentino J,Macdonald RL

    更新日期:2009-07-01 00:00:00

  • Regeneration of the transected rat sciatic nerve after suturing or adhesion with cyanoacrylate glue.

    abstract:OBJECT:Traditional treatment of transected peripheral nerves has been by suturing the nerve ends to each other. Because this approach is not widely available and is technically demanding, the authors evaluated an easier method for end-to-end anastomosis using cyanoacrylate-based glue. METHODS:The authors used a rat sc...

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    pub_type: 杂志文章


    authors: Roth J,Shtokman J,Shamir MH,Nissan M,Shchetinkov L,Trejo LL,Rochkind S

    更新日期:2011-01-01 00:00:00

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    abstract::Tuberculosis continues to be a major public health concern, especially in developing countries. Many types of neurotuberculosis have been described, but there is only one previously reported case of subdural empyema caused by tuberculous bacilli. A 1-year-old boy who had been treated for pulmonary tuberculosis was ref...

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    pub_type: 杂志文章


    authors: Cayli SR,Onal C,Koçak A,Onmuş SH,Tekiner A

    更新日期:2001-06-01 00:00:00

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    abstract:OBJECT:A visual field deficit resulting from the management of an arteriovenous malformation (AVM) significantly impacts a patient's quality of life. The present study was designed to investigate the clinical and radiological outcomes of stereotactic radiosurgery (SRS) performed for AVMs involving the postgeniculate vi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Bowden G,Kano H,Caparosa E,Tonetti D,Niranjan A,Monaco EA 3rd,Flickinger J,Arai Y,Lunsford LD

    更新日期:2015-02-01 00:00:00

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    abstract::The authors report a case of subarachnoid hemorrhage in an 11-month-old infant with tragic outcome. Radiological investigation showed an anterior communicating aneurysm, and postmortem examination confirmed the aneurysm to be a so-called "berry" aneurysm. There were also typical signs of fibromuscular hyperplasia of t...

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    pub_type: 杂志文章


    authors: Bolander H,Hassler O,Liliequist B,West KA

    更新日期:1978-11-01 00:00:00

  • Multiple suture synostosis, macrocephaly, and intracranial hypertension in a child with alpha-D-mannosidase deficiency. Case report.

    abstract::The authors present an unusual case in which increased intracranial pressure developed because of multiple-suture craniosynostosis and megaloencephaly in a child with a previously undiagnosed lysosomal storage disease, alpha-D-mannosidase deficiency. This 3-year-old boy presented with a history of frequent naps, heada...

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    authors: Grabb PA,Albright AL,Zitelli BJ

    更新日期:1995-04-01 00:00:00

  • Clinical evaluation of intravenous nitroglycerin for neurosurgery.

    abstract::Moment-to-moment control of blood pressure is important in the management of the neurosurgical patient. The ideal agent to control blood pressure or induce hypotension should be non-toxic, maintain cerebrovascular autoregulation, and not alter cardiac output or change intracranial pressure. Intravenous nitroglycerin h...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Chestnut JS,Albin MS,Gonzalez-Abola E,Newfield P,Maroon JC

    更新日期:1978-05-01 00:00:00

  • Concurrence of chromosome 6 chromothripsis and glioblastoma metastasis.

    abstract::The authors report an unusual case of a widely metastatic glioblastoma. DNA copy number microarray profile of the resected specimen revealed complex rearrangements found throughout chromosome 6, a phenomenon known as chromothripsis. Such chromothripsis pattern was not observed in 50 nonmetastatic glioblastoma specimen...

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    authors: Rennert RC,Hoshide RR,Signorelli JW,Amaro D,Sack JA,Brennan CW,Chen CC

    更新日期:2017-05-01 00:00:00

  • Suprasellar osteogenic sarcoma following radiation for pituitary adenoma. Case report.

    abstract::The authors report a case in which sellar and suprasellar osteogenic sarcoma developed 10 years after radiation therapy for pituitary adenoma. The literature is reviewed and the rarity of this condition discussed. ...

    journal_title:Journal of neurosurgery

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    authors: Amine AR,Sugar O

    更新日期:1976-01-01 00:00:00

  • The effect of total parenteral nutrition on vasogenic edema development following cold injury in rats.

    abstract::Total parenteral nutrition (TPN) has been shown to decrease mortality and to increase the rate of recovery in head-injured patients. However, a recent short-term animal experiment has raised concern over the potential enhancement of vasogenic edema by TPN. The experiment described here was undertaken to examine longer...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Combs DJ,Ott L,McAninch PS,Dempsey RJ,Young B

    更新日期:1989-04-01 00:00:00

  • Striatal hyperintensity on T1-weighted magnetic resonance images and high-density signal on CT scans obtained in patients with hyperglycemia and no involuntary movement. Report of two cases.

    abstract::The authors report on two patients in whom an increased signal on T1-weighted magnetic resonance images and a high-density signal on computerized tomography scans of the striatum were demonstrated, both of which were associated with nonketotic hyperglycemia. Involuntary movements, which have been present in all previo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sorimachi T,Fujii Y,Tsuchiya N,Saito M

    更新日期:2004-08-01 00:00:00

  • Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus.

    abstract::This series of 228 patients with infantile non-neoplastic hydrocephalus who received either a ventriculoatrial (VA) or a ventriculoperitoneal (VP) shunt before 2 years of age was followed for an average of 7 years, and the results with the two types of shunt were compared. Mortality and infection rates were similar fo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Keucher TR,Mealey J Jr

    更新日期:1979-02-01 00:00:00

  • The transfacet pedicle-sparing approach for thoracic disc removal: cadaveric morphometric analysis and preliminary clinical experience.

    abstract::A number of operative techniques have been described for the treatment of herniated thoracic discs. The transfacet pedicle-sparing approach allows for complete disc removal with limited spinal column disruption and soft-tissue dissection. Fifteen cadaveric spinal columns were used for evaluation of exposure, developme...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Stillerman CB,Chen TC,Day JD,Couldwell WT,Weiss MH

    更新日期:1995-12-01 00:00:00

  • Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact.

    abstract:OBJECT:The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). METHODS:This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Rabinstein AA,Chung SY,Rudzinski LA,Lanzino G

    更新日期:2010-02-01 00:00:00

  • Pentobarbital changes compartmental contribution to cerebral blood flow.

    abstract::Barbiturates were administered to normal dogs, establishing an isoelectric electrocorticogram. Cortical cerebral blood flows (CBF) and deeper CBF's were respectively measured by krypton-85 (85Kr) and xenon-133 (133 Xe). Following barbiturate administration, the two methods of measuring CBF showed a poor coefficient of...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Laurent JP,Lawner P,Simeone FA,Fink E

    更新日期:1982-04-01 00:00:00

  • Alcohol and mortality after moderate to severe traumatic brain injury: a meta-analysis of observational studies.

    abstract::OBJECT Experimental studies have shown numerous neuroprotective properties of alcohol ("ethanol") after TBI, but clinical studies have provided conflicting results. The authors aimed to assess the relationship between positive blood alcohol concentration (BAC) on hospital admission and mortality after moderate to seve...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,多中心研究


    authors: Raj R,Mikkonen ED,Siironen J,Hernesniemi J,Lappalainen J,Skrifvars MB

    更新日期:2016-06-01 00:00:00

  • Occlusion of cerebral artery due to metastasis of chorioepithelioma. Case report.

    abstract::A case of cerebral metastasis of chorioepithelioma with an occlusion of the angular artery is presented. The occlusion was verified angiographically, surgically, and microscopically. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Nakagawa Y,Tashiro K,Isu T,Tsuru M

    更新日期:1979-08-01 00:00:00

  • Stereotaxic implantation of dispersed cell suspensions into brain. A systematic appraisal of cell placement and survival.

    abstract::The application of several recent advances in cell biology, brain implantation, and cell-mediated tumor immunotherapy requires successful and reproducible placement of viable cell suspensions into brain. Stereotaxic implantation is being used to inject cytotoxic lymphocytes into gliomas and to replace dopaminergic cel...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Plunkett RJ,Weber RJ,Oldfield EH

    更新日期:1988-08-01 00:00:00

  • Microsurgical anatomy of the central core of the brain.

    abstract::OBJECTIVE The purpose of this study was to describe in detail the cortical and subcortical anatomy of the central core of the brain, defining its limits, with particular attention to the topography and relationships of the thalamus, basal ganglia, and related white matter pathways and vessels. METHODS The authors stud...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ribas EC,Yağmurlu K,de Oliveira E,Ribas GC,Rhoton A

    更新日期:2018-09-01 00:00:00

  • Influence of smoking on aneurysm recurrence after endovascular treatment of cerebrovascular aneurysms.

    abstract::OBJECTIVE Smoking is a known risk factor for aneurysm development and aneurysmal subarachnoid hemorrhage, as well as subsequent vasospasm in both untreated individuals and patients who have undergone surgical clipping of cerebrovascular aneurysms. However, there is a lack of data in the current scientific literature a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    abstract::The acquired immune deficiency syndrome (AIDS) is a recently described T-cell deficiency predisposing patients to a spectrum of opportunistic infections. Kaposi's sarcoma, and other neoplasms. It appears primarily among homosexual males and intravenous drug abusers, but is now being observed in other groups as well. T...

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    authors: Handler M,Ho V,Whelan M,Budzilovich G

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    abstract::This case illustrates the potential growth rate of an atypical meningioma in a pediatric patient, emphasizes one of the potential risks after therapeutic radiation, and underscores the importance of clinical evaluation and follow up of the symptomatic patient after tumor resection and radiation therapy. The authors re...

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