Gamma knife radiosurgery for Trigeminal Neuralgia. ? Case Report ?

We present two cases with trigeminal neuralgia who underwent gamma knife radiosurgery. Case 1 : 72 years old female suffered from left trigeminal neuralgia. Medical treatment and nerve block were not effective. She underwent gamma knife radiosurgery with a single shot with a maximum dose of 80Gy focused on the root entry zone of the left trigeminal nerve. After the treatment, she showed incomplete pain relief (about 25%). But 6 months after the treatment, she felt intractable pain again, so she underwent microvascular decompression. Case 2: 68 years old female suffered from right trigeminal neuralgia. The effective periods of medical treatment was too short. She underwent gamma knife radiosurgery with a single shot with a maximum dose of 75Gy focused on the same site as Case 1 of the right trigeminal nerve. At 7 months after the treatment, she revealed almost complete pain free and drug free. It has been reported the pain control rate of gamma knife radiosurgery for trigeminal neuralgia is 90-94% and the complication rate is 6-10%. Although the long-term evaluations will be needed, this method seems to be effective and safe treatment for trigeminal neuralgia