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Shaped Beam Radiosurgery pp 195–207Cite as

Radiosurgery for Trigeminal Neuralgia: Indications, Results and Complications

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Abstract

Radiosurgery is the least minimally invasive ablative technique available for the treatment of medically refractory trigeminal neuralgia (TN). The results obtained with radiosurgery are not superior to the results obtained with other techniques. Initial pain relief rates after radiosurgery treatment are high; especially for classical TN, ranging about 85% to 95%. The 3 years actuarial rate of excellent pain outcome (i.e, pain free and medication free) varies from 46% to 53%. Facial numbness is the most frequent complication with variable incidence, ranging from 6% to 54%. Major complications such as anesthesia dolorosa are rare. The convenience of the treatment procedure allied to the absence of major complications is responsible for the establishment of radiosurgery among other surgical modalities. The possibility of frameless radiosurgery performed with modern dedicated-Linac devices makes radiosurgery even more appealing for the patients. The positioning of the isocenter within the cisternal segment of the trigeminal nerve and the prescribed radiation doses vary substantially among the different centers offering radiosurgery for TN as well as radiation dose distribution and nerve length irradiated. The goal of this chapter is to provide a summarized discussion about who are the candidates for radiosurgery, advantages and disadvantages of the technique and a summary of the evidence provided by the use of different radiosurgery treatment protocols. At last, this chapter points the questions that still need to be answered, aiming to optimize the results obtained with radiosurgery so far.

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Authors and Affiliations

  1. Department of Neurosurgery, UCLA Medical Center, David Geffen School of Medicine at UCLA, 300 UCLA Medical Plaza, Suite B212, Los Angeles, CA, 90095, USA

    Alessandra A. Gorgulho

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  1. Alessandra A. Gorgulho
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Correspondence to Alessandra A. Gorgulho .

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Editors and Affiliations

  1. David Geffen School of Medicine at UCLA, Department of Neurosurgery and Radiation, University of California, Le Conte Ave. 10495, Los Angeles, 90095, California, USA

    Antonio A. F. De Salles

  2. UCLA Medical Center, Department of Neurosurgery, University of California, Le Conte Ave 10945, Los Angeles, 90095, California, USA

    Alessandra Gorgulho

  3. David Geffen School of Medicine, Dept. Radiation Oncology, University of California, Los Angeles, UCLA Medical Plaza 200, Los Angeles, 90095, California, USA

    Nzhde Agazaryan

  4. , Department of Radiation Oncology, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV, Netherlands

    Ben Slotman

  5. David Geffen School of Medicine at UCLA, Department of Radiation Oncology, University of California, UCLA Medical Plaza 200, Los Angeles, 90095, California, USA

    Michael Selch

  6. BrainLAB, Inc., Westbrook Corporate Center 3, Westchester, 60154, Illinois, USA

    Aaaron J. Burwick

  7. Shaped-Beam Radiosurgery, Varian Medical Systems, Inc., Hansen Way 3100, Palo Alto, 94304, California, USA

    Raymond Schulz

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© 2011 Springer-Verlag Berlin Heidelberg

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Gorgulho, A.A. (2011). Radiosurgery for Trigeminal Neuralgia: Indications, Results and Complications. In: De Salles, A., et al. Shaped Beam Radiosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11151-8_17

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  • DOI: https://doi.org/10.1007/978-3-642-11151-8_17

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