{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:51:00Z","timestamp":1792176660052,"version":"4.4.0"},"reference-count":51,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nIn the present study, we evaluate the results of gamma knife surgery (GKS) for the treatment of trigeminal neuralgia (TN) using the trigeminal ganglion (TG\u2019) and the adjacent fibers of trigeminal nerve as a target.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nFrom February 2013 to July 2017, we treated 30 cases of TN with GKS. In this group, all patients had an idiopathic typical TN. The radiosurgical target was conformed through two isocenters, 8 and 4 mm at the cavum de Meckel. The maximum dose was 86 Gy using the isodose line of 50%. The median age of the patients was 58.5 (range 28\u201394) years old, and the median time from diagnosis to GKS was 94 months (range 13\u2013480 months). The median follow-up was 28.5 (range 12\u201349) months. Clinical outcomes were analyzed. Univariate and multivariate analyses were performed to evaluate factors that correlated with a favorable, pain-free outcome.<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nThe mean time to relief of pain was 7 (range 1\u201340) days. The percentage of patients with significant pain relief was 93.3%. Relapse in pain was noted in four patients at 3, 16, 19, and 36 months. Nine patients were treated in acute status. Fourteen patients had intense pain between 1 and 7 days before the procedure. Among those with the recurrence of their symptoms, one patient had a microvascular decompression. Multivariate regression adjusted for age and sex suggests that, by 40 months, 70% of the patients treated with radiosurgery will remain pain free. At the last follow-up, GKS resulted in pain relief in 86.6% of patients. Our analysis suggests that, using this technique, we can expect that approximately 70% of patients with TN will have some degree of pain improvement at 3 years\u2019 post radiosurgery.<\/jats:p>\n<\/jats:sec>\n\nConclusions: <\/jats:title>\nGKS on TG appears to be a reasonable treatment option with short latency period, minor collateral effects, and high percentage of pain control. The mechanism of action of radiosurgery could be related to the inactivation of the satellite glial cells in the TG.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni-134-2019","type":"journal-article","created":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T11:59:50Z","timestamp":1566734390000},"page":"89","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Gamma knife radiosurgery on the trigeminal ganglion for idiopathic trigeminal neuralgia: Results and review of the literature"],"prefix":"10.25259","volume":"10","author":[{"given":"Salvador","family":"Somaza","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, Centro Diagnostico Docente Las Mercedes, Hospital de Clinicas Caracas, Caracas, Venezuela,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eglee M.","family":"Montilla","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, Centro Diagnostico Docente Las Mercedes, Hospital de Clinicas Caracas, Caracas, Venezuela,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Mora","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2019,6,7]]},"reference":[{"key":"10.25259\/SNI-134-2019\/ref-1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3171\/jns.2005.102.s_supplement.0185","article-title":"Gamma knife surgery for trigeminal neuralgia: Improved initial response with two isocenters and increasing dose","author":"Alpert","year":"2005","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-134-2019\/ref-2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jocn.2016.12.026","article-title":"De novo superior cerebellar artery aneurysm following radiosurgery for trigeminal neuralgia","volume":"38","author":"Chen","year":"2017","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI-134-2019\/ref-3","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1055\/s-0030-1269926","article-title":"X-knife stereotactic radiosurgery on the trigeminal ganglion to treat trigeminal neuralgia: A preliminary study","volume":"53","author":"Chen","year":"2010","journal-title":"Minim Invasive Neurosurg"},{"key":"10.25259\/SNI-134-2019\/ref-4","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.bjan.2013.07.013","article-title":"Satellite glial cells in sensory ganglia: Its role in pain","volume":"65","author":"Costa","year":"2015","journal-title":"Rev Bras Anestesiol"},{"key":"10.25259\/SNI-134-2019\/ref-5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.3171\/JNS\/2008\/109\/12\/S26","article-title":"Clinical outcomes after gamma knife surgery for idiopathic trigeminal neuralgia: Review of 76 consecutive cases","author":"Dellaretti","year":"2008","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-134-2019\/ref-6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/00002508-200201000-00002","article-title":"Pathophysiology of trigeminal neuralgia: The ignition hypothesis","volume":"18","author":"Devor","year":"2002","journal-title":"Clin J Pain"},{"key":"10.25259\/SNI-134-2019\/ref-7","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3171\/2009.2.JNS08977","article-title":"Long-term outcomes of gamma knife radiosurgery for classic trigeminal neuralgia: Implications of treatment and critical review of the literature. 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