{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:11:53Z","timestamp":1778022713268,"version":"3.51.4"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The surgical options for medically refractory trigeminal neuralgia (TN) are diverse, with limited comparative evidence. This study evaluates and compares pain-free period and time to recurrence for patients who underwent microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and radiofrequency ablation (RFA).<\/jats:p>\n                  <jats:p>A retrospective review of patients with medically refractory TN over a 10-year period from 2009 to 2018 at a tertiary neurosurgical center was performed. Patients with at least 1 year of follow-up after the treatment procedure were included. Clinical details, radiological records, intraoperative findings, and treatment details of radiosurgery and ablative procedures were recorded.<\/jats:p>\n                  <jats:p>A total of 189 patients were included, the mean age being 52.54 (\u00b1\u200913.3) years, with a male:female ratio of 1.52:1. The mean duration of symptoms was 70.19 (\u00b1\u200957.6) months, with 86.3% of patients presenting with type 1 neuralgia. The median follow-up duration was 84, 100, and 67 months for MVD, GKRS, and RFA, respectively. The percentages of patients with favorable outcomes (Barrow Neurological Institute Pain Intensity Score [BNI I\u2013IIIa]) were 87.8, 67.3, and 66.5%, respectively, for MVD, GKRS, and RFA. The median pain-free intervals were 65, 59, and 36 months, with recurrence rates of 24.2, 25, and 40.5% for MVD, GKRS, and RFA, respectively.<\/jats:p>\n                  <jats:p>This study reaffirms MVD as the best first-line treatment for medically refractory TN, with GKRS being a useful alternative in patients who are surgically unfit or unwilling, and an optimum second-line treatment for those with recurrences. RFA is useful as an adjunct in patients unfit for surgery, with a high initial efficacy albeit with high recurrence rates.<\/jats:p>","DOI":"10.1055\/a-2639-5914","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T19:07:15Z","timestamp":1750273635000},"page":"268-275","source":"Crossref","is-referenced-by-count":0,"title":["Medically Refractory Trigeminal Neuralgia: A Comparative Study of Outcomes of Microvascular Decompression versus Gamma Knife Radiosurgery and Percutaneous Radiofrequency Ablation"],"prefix":"10.1055","volume":"87","author":[{"given":"Kevin J.","family":"Sudevan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhusudhan","family":"Nagesh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5986-1521","authenticated-orcid":false,"given":"Andiperumal R.","family":"Prabhuraj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nupur","family":"Pruthi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preetham","family":"Dange","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sattar","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Beniwal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0509-4993","authenticated-orcid":false,"given":"Nishanth","family":"Sadashiva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Vazhayil","sequence":"additional","affiliation":[{"name":"Department of 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