{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:14:41Z","timestamp":1790144081477,"version":"4.0.1"},"reference-count":35,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,7]]},"abstract":"\nObject<\/jats:title>\nTrigeminal neuralgia is believed to be related to vascular compression of the affected nerve. Radiosurgery has been shown to be reasonably effective for treatment of medically refractory trigeminal neuralgia. This study explores the rate of occurrence of MR imaging\u2013demonstrated vascular impingement of the affected nerve and the extent to which vascular impingement affects pain relief in a population of trigeminal neuralgia patients undergoing Gamma Knife radiosurgery (GKRS).<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe authors performed a retrospective analysis of 106 cases involving patients treated for typical trigeminal neuralgia using GKRS. Patients with or without single-vessel impingement on CISS MR imaging sequences and with no previous surgery were included in the study. Pain relief was assessed according to the Barrow Neurological Institute (BNI) pain intensity score at the last follow-up. Degree of impingement, nerve diameter preand post-impingement, isocenter placement, and dose to the point of maximum impingement were evaluated in relation to the improvement of BNI score.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe overall median follow-up period was 31 months. Overall, a BNI pain score of 1 was achieved in 59.4% of patients at last follow-up. Vessel impingement was seen in 63 patients (59%). There was no significant difference in pain relief between those with and without vascular impingement following GKRS (p > 0.05).<\/jats:p>\nIn those with vascular impingement on MR imaging, the median fraction of vessel impingement was 0.3 (range 0.04\u20130.59). The median dose to the site of maximum impingement was 42 Gy (range 2.9\u201379 Gy). Increased dose (p = 0.019) and closer proximity of the isocenter to the site of maximum vessel impingement (p = 0.012) correlated in a statistically significant fashion with improved BNI scores in those demonstrating vascular impingement on the GKRS planning MR imaging<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nVascular impingement of the affected nerve was seen in the majority of patients with trigeminal neuralgia. Overall pain relief following GKRS was comparable in those with and without evidence of vascular compression on MR imaging. In subgroup analysis of those with MR imaging evidence of vessel impingement of the affected trigeminal nerve, pain relief correlated with a higher dose to the point of contact between the impinging vessel and the trigeminal nerve. Such a finding may point to vascular changes affording at least some degree of relief following GKRS for trigeminal neuralgia.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.9.jns09196","type":"journal-article","created":{"date-parts":[[2009,10,23]],"date-time":"2009-10-23T12:24:37Z","timestamp":1256300677000},"page":"53-58","source":"Crossref","is-referenced-by-count":31,"title":["Gamma Knife radiosurgery for trigeminal neuralgia: the impact of magnetic resonance imaging\u2013detected vascular impingement of the affected nerve"],"prefix":"10.3171","volume":"113","author":[{"given":"Jason P.","family":"Sheehan","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dibyendu Kumar","family":"Ray","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Monteith","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Po","family":"Yen","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lesnick","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of Virginia, Charlottesville; and Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Kersh","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Riverside Medical Center, Newport News, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schlesinger","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns09196","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1020","article-title":"The treatment of trigeminal neuralgia by posterior fossa microsurgery","volume":"45","author":"Adams","year":"1982"},{"key":"b2-jns09196","series-title":"N Engl J Med","first-page":"1077","article-title":"The long-term outcome of microvascular decompression for trigeminal neuralgia","volume":"334","author":"Barker","year":"1996"},{"key":"b3-jns09196","series-title":"BMJ","first-page":"201","article-title":"Trigeminal neuralgia and its management","volume":"334","author":"Bennetto","year":"2007"},{"key":"b4-jns09196","series-title":"J Neurosurg","first-page":"431","article-title":"Gamma Knife and trigeminal neuralgia","volume":"102","author":"Burchiel","year":"2005"},{"key":"b5-jns09196","series-title":"AJNR Am J Neuroradiol","first-page":"47","article-title":"Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle","volume":"14","author":"Casselman","year":"1993"},{"key":"b6-jns09196","series-title":"Am J Surg","first-page":"447","article-title":"Concerning the cause of trigeminal neuralgia","volume":"24","author":"Dandy","year":"1934"},{"key":"b7-jns09196","series-title":"Int J Radiat Oncol Biol Phys","first-page":"449","article-title":"Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? 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