{"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":1792176660035,"version":"4.4.0"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Supplement","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Gamma Knife surgery (GKS) is an important part of the neurosurgical armamentarium for treatment of patients with trigeminal neuralgia (TN) and is regarded as the first-line treatment in patients with TN who have serious medical comorbidities. In this study, the authors investigated the efficacy of GKS on TN in patients with serious medical comorbidities.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between May 2004 and September 2007, 52 severely ill patients who also had TN with Barrow Neurological Institute (BNI) facial pain scores of IV or V were entered into this study. The patients' medical records and imaging findings were reviewed by an anesthesiologist and neurosurgeons to determine whether GKS was a reasonable approach to palliate the patient's pain. All patients underwent GKS, in which a maximum dose of 80 Gy was targeted to the trigeminal nerve with or without plugging to keep the dose received by the brainstem at less than 16 Gy. After treatment, every patient had clinical follow-up every 1\u20133 months and filled out questionnaires designed to assess BNI facial pain and numbness scores, visual analog scale scores, and 36-Item Short Form Health Survey (SF-36) scores every 3 months until the end of the study. Statistical analysis was performed to find favorable prognostic factors related to pain relief and changes in quality of life.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The median age of the patients was 71 years, and the male\/female ratio was 30:22. The median follow-up period was 54 months (at least 2 years). All patients had a positive initial response to GKS, with BNI facial pain scores at least 1 point less than respective pre-GKS scores. Three patients (5.7%) obtained BNI facial pain Score I. Twenty-three patients (44.2%) experienced pain recurrence at a median follow-up of 33 months. One patient suffered from angina and required time in an intensive care unit; another patient had bleeding from a pin wound that required suturing. Alterations in BNI scores were highly correlated to visual analog scale scores (R2 = 0.978). In both univariate and multivariate analyses, a decreased BNI facial pain score at different time points was significantly (p &lt; 0.05) related to younger patient age, no previous treatment, evidence of vessel compression on MR imaging, time of first GKS \u2264 24 months, physical function (SF-36), role limitation due to a physical problem (SF-36), role limitation due to an emotional problem (SF-36), mental health (SF-36), social functioning (SF-36), bodily pain (SF-36), and general health (SF-36), but was not related to vitality (SF-36). Five patients (9.6%) experienced facial numbness at a mean of 13.2 \u00b1 3.1 months after GKS (4 patients with BNI facial numbness Score II and 1 with BNI facial numbness Score III). Post-GKS MR imaging changes, including focal contrast enhancement or T2-weighted signal alterations, were identified in 3 patients (5.7%).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Gamma Knife surgery produced significant pain relief in severely ill patients who had TN without causing appreciable morbidity. The effect of reduced pain significantly paralleled an improvement in SF-36 quality-of-life indices.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.8.gks10879","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T01:09:47Z","timestamp":1542330587000},"page":"191-198","source":"Crossref","is-referenced-by-count":22,"title":["Quality-of-life outcomes after Gamma Knife surgery for trigeminal neuralgia"],"prefix":"10.3171","volume":"113","author":[{"given":"Hung-Chuan","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Taichung Veterans General Hospital, Taichung;"},{"name":"Institute of Biomedical Sciences, National Chung-Hsing University, Taichung;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan-Fu","family":"Huang","sequence":"additional","affiliation":[{"name":"Chung-Shan Medical University, Taichung;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meei-Ling","family":"Sheu","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Sciences, National Chung-Hsing University, Taichung;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dar-Yu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chang Bing Show Chwan Memorial Hospital, Changhua; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Ta","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1130191","series-title":"Clin Neurol Neurosurg","first-page":"174","article-title":"Gamma knife radiosurgery in patients with trigeminal neuralgia: quality of life, outcomes, and complications","volume":"111","author":"Azar","year":"2009"},{"key":"b2-1130191","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":"b3-1130191","series-title":"Neurosurgery","first-page":"1261","article-title":"Trigeminal nerve-blood vessel relationship as revealed by high-resolution magnetic resonance imaging and its effect on pain relief after gamma knife radiosurgery for trigeminal neuralgia","volume":"50","author":"Brisman","year":"2002"},{"issue":"Suppl 3","key":"b4-1130191","series-title":"J Neurosurg","first-page":"155","article-title":"Gamma knife radiosurgery for trigeminal neuralgia: dose-volume histograms of the brainstem and trigeminal nerve","volume":"93","author":"Brisman","year":"2000"},{"key":"b5-1130191","series-title":"Neurosurgery","first-page":"783","article-title":"Long-term results of percutaneous retrogasserian thermorhizotomy for \u201cessential\u201d trigeminal neuralgia: considerations in 1000 consecutive patients","volume":"26","author":"Broggi","year":"1990"},{"key":"b6-1130191","series-title":"Neurosurg Clin N Am","first-page":"53","article-title":"Percutaneous balloon compression of the trigeminal nerve","volume":"8","author":"Brown","year":"1997"},{"key":"b7-1130191","series-title":"Neurosurgery","first-page":"570","article-title":"Percutaneous trigeminal nerve compression for treatment of trigeminal neuralgia: results in 50 patients","volume":"32","author":"Brown","year":"1993"},{"key":"b8-1130191","series-title":"J Neurosurg","first-page":"35","article-title":"Long-term efficacy of microvascular decompression in trigeminal neuralgia","volume":"69","author":"Burchiel","year":"1988"},{"issue":"Suppl 3","key":"b9-1130191","series-title":"J Neurosurg","first-page":"147","article-title":"Gamma knife radiosurgery for idiopathic and secondary trigeminal neuralgia","volume":"93","author":"Chang","year":"2000"},{"key":"b10-1130191","series-title":"J Neurosurg","first-page":"351","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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