Gamma Knife Radiosurgery for SUNCT: A Case Series.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.1159/000528632

Andrea Franzini, Davide Milani, Luca Attuati, Pierina Navarria, Federico Pessina, Piero Picozzi

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引用次数: 1

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.

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伽玛刀放射外科治疗SUNCT:一个病例系列。

背景:用结膜注射和撕裂(SUNCT)治疗难治性慢性短期单侧神经痛性头痛患者是具有挑战性的。立体定向放射治疗三叉神经和蝶腭神经节(SPG)已被用作一种微创治疗。在一些病例报告中描述了该手术的结果。目的:本研究的目的是报告伽玛刀放射治疗(GKRS)在5例慢性SUNCT患者中的效果。方法:回顾性分析我们的GKRS数据库，发现5例慢性SUNCT患者接受了针对三叉神经和SPG的GKRS。三叉神经和SPG的最大剂量分别为80 ~ 85 Gy和80 Gy。疼痛强度和面部麻木采用巴罗神经学研究所(BNI)评分进行评估。结果:5例患者临床随访时间平均26.2个月。在2天至9个月的时间内，GKRS成功地减轻了所有5例患者的疼痛发作和自主神经症状。在最后的评估中，分别有1例、1例和3例患者的BNI疼痛评分达到I、II和IIIa。结论:这5例患者表明，GKRS同时靶向三叉神经和SPG，可有效减轻SUNCT患者的疼痛和自主神经症状，尽管可能出现非疼痛性三叉神经感觉障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.