Stereotactic and Functional Neurosurgery

Franzini A.a· Milani D.a· Attuati L.a· Navarria P.b· Pessina F.a,c· Picozzi P.a

Author affiliations

aDepartment of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
bDepartment of Radiation Oncology, IRCCS Humanitas Research Hospital, Milan, Italy
cDepartment of Biomedical Sciences, Humanitas University, Milan, Italy

Stereotact Funct Neurosurg

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Article / Publication Details

First-Page Preview

Received: October 08, 2022
Accepted: December 03, 2022
Published online: February 02, 2023

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Abstract

Background: The treatment of medically refractory patients with chronic short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is challenging. Stereotactic radiosurgery targeting the trigeminal nerve and sphenopalatine ganglion (SPG) has been used as a less-invasive treatment. The outcomes of this procedure have been described in a few case reports. Objectives: The objective of the study was to report on the effect of Gamma Knife radiosurgery (GKRS) in 5 patients with chronic SUNCT. Methods: Retrospective review of our GKRS database identified 5 patients with chronic SUNCT who underwent GKRS targeted to the trigeminal nerve and SPG. A maximum dose of 80–85 Gy and 80 Gy was, respectively, delivered to the trigeminal nerve and SPG. Pain intensity and facial numbness were evaluated using the Barrow Neurological Institute (BNI) scores. Results: These 5 patients were clinically followed for a mean period of 26.2 months. Within a period ranging from 2 days to 9 months, GKRS was successful in reducing pain attacks and autonomic symptoms in all 5 patients. At the last assessments, BNI pain scores of I, II, and IIIa were achieved in 1, 1, and 3 patients, respectively. Two patients developed nonbothersome facial numbness (BNI facial numbness score II). Conclusions: These 5 cases show that GKRS targeted to both the trigeminal nerve and the SPG is effective in reducing pain and autonomic symptoms of patients with SUNCT, although nonbothersome trigeminal sensory disturbances may occur.

© 2023 S. Karger AG, Basel

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First-Page Preview

Received: October 08, 2022
Accepted: December 03, 2022
Published online: February 02, 2023

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

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