{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:35:20Z","timestamp":1793406920959,"version":"4.5.0"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Gamma Knife surgery (GKS) has been shown to be effective in treating trigeminal neuralgia (TN). Existing studies have demonstrated success rates of 69.1\u201385% with median follow-up intervals of 19\u201360 months. However, series with uniform long-term follow-up data for all patients have been lacking. In the present study the authors examined outcomes in a series of patients with TN who underwent a single GKS treatment followed by a minimum follow-up of 36 months. They used a clinical scale that simplifies the reporting of outcome data for patients with TN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-three consecutive patients with typical, intractable TN received a median maximum radiation dose of 80 Gy applied with a single 4-mm isocenter to the affected trigeminal nerve. Follow-up data were obtained by clinical examination and questionnaire. Outcome results were categorized into the following classes (in order of decreasing success): Class 1A, complete pain relief without medications; 1B, complete pain relief with either a decrease or no change in medications; 1C, \u2265 50% pain relief without medications; 1D, \u2265 50% pain relief with either a decrease or no change in medications; and Class 2, &lt; 50% pain relief and\/or increase in medications. Patients with Class 1A\u20131D outcome (equivalent to Barrow Neurological Institute Grades I\u2013IIIb) were considered to have a good treatment outcome, whereas in patients with Class 2 outcome (equivalent to Barrow Neurological Institute Grades IV and V) treatment was considered to have failed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A good treatment outcome from initial GKS was achieved in 31 (58.5%) patients for whom the mean follow-up period was 48 months (range 36\u201366 months). Outcomes at last follow-up were reflected by class status: Class 1A, 32.1% of patients; 1B, 1.9%; 1C, 3.8%; 1D, 20.8%; and Class 2, 41.5%. Statistical analysis showed no difference in outcomes between patients previously treated with microvascular decompression or rhizotomy compared with patients with no previous surgical treatments. Thirty-six percent of patients reported some degree of posttreatment facial numbness. Anesthesia dolorosa did not develop in any patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite a time-dependent deterioration in the success rate of GKS for medically intractable TN, the authors' study showed that &gt; 50% of patients can be expected to have a good outcome based on their scoring system, with ~ 33% having an ideal outcome (pain free with no need for medications). Long-term data, as those presented here, are important when counseling patients on their treatment options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2009.8.jns081706","type":"journal-article","created":{"date-parts":[[2009,9,25]],"date-time":"2009-09-25T14:17:18Z","timestamp":1253888238000},"page":"766-771","source":"Crossref","is-referenced-by-count":68,"title":["Outcomes following single-treatment Gamma Knife surgery for trigeminal neuralgia with a minimum 3-year follow-up"],"prefix":"10.3171","volume":"112","author":[{"given":"Ron I.","family":"Riesenburger","sequence":"first","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven W.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens M.","family":"Schirmer","sequence":"additional","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilios","family":"Zerris","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Texas A&M University, Temple, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian K.","family":"Wu","sequence":"additional","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Mahn","sequence":"additional","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[{"name":"Wright-Patterson Air Force Base, Dayton, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mignano","sequence":"additional","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clinton J.","family":"Thompson","sequence":"additional","affiliation":[{"name":"School of Public Health and Health Services, George Washington University, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.","family":"Yao","sequence":"additional","affiliation":[{"name":"Boston Gamma Knife Center at Tufts Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120766","series-title":"J Neurosurg","first-page":"730","article-title":"Does dose rate affect efficacy? 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