NDLI: Long-term outcome of high-dose Î³ knife surgery in treatment of trigeminal neuralgia.

Please wait, while we are loading the content...

Year: 2017 Volume: 126

Year: 2016 Volume: 2016

Year: 2016 Volume: 125

Year: 2016 Volume: 124

Year: 2015 Volume: 123

Year: 2015 Volume: 123 Spec Suppl

Year: 2015 Volume: 122

Year: 2014 Volume: 121

Year: 2014 Volume: 120

Year: 2013 Volume: 119

Year: 2013 Volume: 119 Issue: 6

Year: 2013 Volume: 119 Issue: 5

Foramen ovale puncture, lesioning accuracy, and avoiding complications: microsurgical anatomy study with clinical implications.

Long-term outcome of high-dose Î³ knife surgery in treatment of trigeminal neuralgia.

The relationship between the superior petrosal sinus and the porus trigeminus: an anatomical study.

The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study.

Predictors of mortality in nontraumatic subdural hematoma.

The impact of smoking on neurosurgical outcomes.

Î³ knife surgery anterior capsulotomy for severe and refractory obsessive-compulsive disorder.

Temporal bone encephalocele and cerebrospinal fluid fistula repair utilizing the middle cranial fossa or combined mastoid-middle cranial fossa approach.

Intracranial pressure monitoring for brain injury.

Endoscopic endonasal surgery for craniopharyngiomas: surgical outcome in 64 patients.

Transsylvian hippocampal transection for mesial temporal lobe epilepsy: surgical indications, procedure, and postoperative seizure and memory outcomes.

Closed head injury.

Decreased risk of acute kidney injury with intracranial pressure monitoring in patients with moderate or severe brain injury.

D-dimer plasma level: a reliable marker for venous thromboembolism after elective craniotomy.

Functional mapping.

Right parietal cortex and calculation processing: intraoperative functional mapping of multiplication and addition in patients affected by a brain tumor.

Microelectrode recording and deep brain stimulation.

Outcome prediction in traumatic brain injury.

Massive cerebral involvement in fat embolism syndrome and intracranial pressure management.

Beta-amyloid oligomer.

Partly reversible central auditory dysfunction induced by cerebral vasospasm after subarachnoid hemorrhage.

Role of subconcussion in repetitive mild traumatic brain injury.

Intracranial pressure monitoring in severe head injury: compliance with Brain Trauma Foundation guidelines and effect on outcomes: a prospective study.

Electrostatic discharges and their effect on the validity of registered values in intracranial pressure monitors.

Treatment guidelines from the Brain Trauma Foundation.

Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery.

Subconcussion in traumatic brain injury.

Diffuse low-grade gliomas.

Hypertension in patients with cranial nerve vascular compression syndromes and comparison with a population-based cohort.

Stereotactic radiosurgery used to manage a meningioma filling the posterior two-thirds of the superior sagittal sinus.

Cognitive assessment in glioma patients.

Expansion of CD133-positive glioma cells in recurrent de novo glioblastomas after radiotherapy and chemotherapy.

Risks for hemorrhagic complications after placement of external ventricular drains with early chemical prophylaxis against venous thromboembolisms.

Indocyanine green videography and meningioma.

Cadherin 13 overexpression as an important factor related to the absence of tumor fluorescence in 5-aminolevulinic acid-guided resection of glioma.

The biological advantage of single-session radiosurgery.

Effect of symptomatic pseudomeningocele on improvement in pain, disability, and quality of life following suboccipital decompression for adult Chiari malformation type I.

Nonthermal ablation with microbubble-enhanced focused ultrasound close to the optic tract without affecting nerve function.

The impact of radiosurgery fractionation and tumor radiobiology on the local control of brain metastases.

A technique to identify core journals for neurosurgery using citation scatter analysis and the Bradford distribution across neurosurgery journals.

Medial temporal epilepsy.

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies.

Intracranial biomechanics following cortical contusion in live rats.

Occipital lobe.

Year: 2013 Volume: 119 Issue: 4

Year: 2013 Volume: 119 Issue: 3

Year: 2013 Volume: 119 Issue: 2

Year: 2013 Volume: 119 Issue: 1

Year: 2013 Volume: 119 Issue: Supplementary

Year: 2013 Volume: 118

Year: 2012 Volume: 117

Year: 2012 Volume: 116

Year: 2011 Volume: 115

Year: 2011 Volume: 114

Year: 2010 Volume: 113

Year: 2010 Volume: 112

Year: 2009 Volume: 111

Long-term outcome of high-dose Î³ knife surgery in treatment of trigeminal neuralgia.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Young, Byron Shivazad, Armin Kryscio, Richard J. St Clair, William Bush, Heather M.
Description	Author Affiliation: Young B ( Departments of Neurosurgery.)
Abstract	OBJECT: Despite the widespread use of Gamma Knife surgery (GKS) for trigeminal neuralgia (TN), controversy remains regarding the optimal treatment dose and target site. Among the published studies, only a few have focused on long-term outcomes (beyond 2 years) using 90 Gy, which is in the higher range of treatment doses used (70-90 Gy). METHODS: The authors followed up on 315 consecutive patients treated with the Leksell Gamma Knife unit using a 4-mm isocenter without blocks. The isocenter was placed on the trigeminal nerve with the 20% isodose line tangential to the pontine surface (18 Gy). At follow-up, 33 patients were deceased; 282 were mailed an extensive questionnaire regarding their outcomes, but 32 could not be reached. The authors report their analysis of the remaining 250 cases. The patients' mean age at the time of survey response and the mean duration of follow-up were 70.8 ± 13.1 years and 68.9 ± 41.8 months, respectively. RESULTS: One hundred eighty-five patients (85.6%) had decreased pain intensity after GKS. Modified Marseille Scale (MMS) pain classifications after GKS at follow-up were: Class I (pain free without medication[s]) in 104 (43.7%), Class II (pain free with medication[s]) in 66 (27.7%), Class III (> 90% decrease in pain intensity) in 23 (9.7%), Class IV (50%-90% decrease in pain intensity) in 20 (8.4%), Class V (< 50% decrease in pain intensity) in 11 (4.6%), and Class VI (pain becoming worse) in 14 (5.9%). Therefore, 170 patients (71.4%) were pain free (Classes I and II) and 213 (89.5%) had at least 50% pain relief. All patients had pain that was refractory to medical management prior to GKS, but only 111 (44.4%) were being treated with medication at follow-up (p < 0.0001). Eighty patients (32.9%) developed numbness after GKS, and 74.5% of patients with numbness had complete pain relief. Quality of life and patient satisfaction on a 10-point scale were reported at mean values (± SD) of 7.8 ± 3.1 and 7.7 ± 3.4, respectively. Most of the patients (87.7%) would recommend GKS to another patient. Patients with prior surgical treatments had increased latency to pain relief and were more likely to continue medicines (p < 0.05). Moreover, presence of altered facial sensations prior to radiosurgery was associated with higher pain intensity, longer pain episodes, more frequent pain attacks, worse MMS pain classification, and more medication use after GKS (p < 0.05). Conversely, increase in numbness intensity after GKS was associated with a decrease in pain intensity and pain length (p < 0.05). CONCLUSIONS: Gamma Knife surgery using a maximum dose of 90 Gy to the trigeminal nerve provides satisfactory long-term pain control, reduces the use of medication, and improves quality of life. Physicians must be aware that higher doses may be associated with an increase in bothersome sensory complications. The benefits and risks of higher dose selection must be carefully discussed with patients, since facial numbness, even if bothersome, may be an acceptable trade-off for patients with severe pain.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	5
Volume Number	119
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2013-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Pain Surgery Radiosurgery Trigeminal Neuralgia Physiopathology Pain Measurement Patient Satisfaction Quality Of Life Psychology Radiation Dosage Adverse Effects Time Factors
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

Central Library (ISO-9001:2015 Certified)
Indian Institute of Technology Kharagpur
Kharagpur, West Bengal, India | PIN - 721302

See location in the Map
03222 282435
Mail: support@ndl.gov.in

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in