Effect of the Gamma Knife on trigeminal neuralgia.

The Gamma Knife radiosurgical treatment of 20 patients suffering from trigeminal neuralgia is reported. Eleven patients received radiosurgical treatment with the goal of pain relief. Six had secondary trigeminal neuralgia due to AVM, large cavernous sinus and petrous bone meningiomas, trigeminal neurinoma, or chordoma; 5 others had essential trigeminal neuralgia. Radiosurgical treatment was considered only after the failure of conventional medical and surgical treatment. For the other 9 patients, the control of the tumor was the main objective (four acoustic and one trigeminal neurinoma, one petroclival chordoma, and three tumors of the cavernous sinus: one hemangiopericytoma, one metastasis, one meningioma). We have not been using this method for sufficient time to evaluate long-term results. However, we believe that a large majority of our patients benefited greatly from this technique with a rapid clinical improvement, which is a reflection of the relevance of the chosen target.