Effect of Arterial Pressure Site Definition on Outcomes of Trigeminal Neuralgia Gamma Knife

Abstract

Background: Trigeminal neuralgia is one of the most persecutor pains of the face. Pain is usually lancet form and aggravates with eating and speaking. Gamma knife radiosurgery is used for treatment of refractory pain.

In this study we evaluated effect of gamma knife on proximal site of trigeminal nerve adjacent to inducement artery.

Materials and Methods: In this retrospective study, 212 patients (age:50±10 year) between 2002 – 2011 selected in Iran Gamma Knife Center and divided to two groups.

180 patient without arterial pressure site emplacement and 32 with accurate definition of proximal nerve to artery, underwent gamma knife radiosurgery.

Results: From the 180 patients that arterial compression site on fifth cranial nerve was not defined, gamma knife radiosugery led to facial pain reduction or improvement in 75% of patients during the first year, while this rate was 90% in 32 patients of group 2. These proportions decreased to 60 and 80 percent in the end of second year, respectively. Impossibility to determine the exact location of arterial site near to the fifth nerve in all patients.

Conclusions: Our study shows that localization of arterial compression site of involved trigeminal nerve results in significant increase in improvement or pain reduction after Gamma knife.  Gamma knife planning by determining the location of the proximal nerve adjacent to the artery.