Simultaneous Treatment of Petroclival Meningiomas and the Trigeminal Nerve with Gamma Knife Radiosurgery for Tumor-Related Trigeminal Neuralgia.
Gamma knife radiosurgery
Petroclival meningioma
Stereotactic radiosurgery
Trigeminal neuralgia
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
06
03
2020
revised:
07
04
2020
accepted:
09
04
2020
pubmed:
25
4
2020
medline:
4
9
2020
entrez:
25
4
2020
Statut:
ppublish
Résumé
Some petroclival meningiomas cause trigeminal nerve compression, leading to disabling trigeminal neuralgia (TN). Tumor resection and nerve decompression can offer pain relief but might not be feasible in all patients. Simultaneous stereotactic radiosurgery (SRS) to the tumor and nerve is another option. SRS is an effective means of treating meningiomas and TN separately, but data on the efficacy and outcomes of their concomitant treatment are limited. We report a series of 4 patients who presented with TN secondary to a petroclival mass causing compression of the trigeminal nerve. All patients underwent SRS to both the petroclival mass and trigeminal nerve in a single session. The average margin tumor dose was 12.25 Gy (range, 12-12.5 Gy), and the average maximum trigeminal nerve dose was 80 Gy (range, 75-85 Gy). In all patients, before intervention, the Barrow Neurologic Institute (BNI) pain intensity score was grade IV or V. At last follow-up (average, 29.8 months), all patients were pain-free (BNI I or IIIA). Two patients experienced reduced facial sensation in 1 or all 3 distributions. No brainstem edema was seen. This series highlights the benefits and safety of simultaneous treatment of petroclival tumors and the trigeminal nerve in a single session for patients affected by tumor-related TN.
Sections du résumé
BACKGROUND
Some petroclival meningiomas cause trigeminal nerve compression, leading to disabling trigeminal neuralgia (TN). Tumor resection and nerve decompression can offer pain relief but might not be feasible in all patients. Simultaneous stereotactic radiosurgery (SRS) to the tumor and nerve is another option. SRS is an effective means of treating meningiomas and TN separately, but data on the efficacy and outcomes of their concomitant treatment are limited.
CASE DESCRIPTION
We report a series of 4 patients who presented with TN secondary to a petroclival mass causing compression of the trigeminal nerve. All patients underwent SRS to both the petroclival mass and trigeminal nerve in a single session. The average margin tumor dose was 12.25 Gy (range, 12-12.5 Gy), and the average maximum trigeminal nerve dose was 80 Gy (range, 75-85 Gy). In all patients, before intervention, the Barrow Neurologic Institute (BNI) pain intensity score was grade IV or V. At last follow-up (average, 29.8 months), all patients were pain-free (BNI I or IIIA). Two patients experienced reduced facial sensation in 1 or all 3 distributions. No brainstem edema was seen.
CONCLUSIONS
This series highlights the benefits and safety of simultaneous treatment of petroclival tumors and the trigeminal nerve in a single session for patients affected by tumor-related TN.
Identifiants
pubmed: 32330619
pii: S1878-8750(20)30789-0
doi: 10.1016/j.wneu.2020.04.082
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
242-244Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.