Stereotactic and Functional Neurosurgery最新文献

{"title":"Lack of Therapeutic Benefit of Vim Thalamotomy for Tremor-like Myoclonus in Two Cases of Benign Adult Familial Myoclonus Epilepsy.","authors":"Taku Nonaka, Takashi Asahi, Shiro Horisawa, Ichiro Takumi, Kiyonobu Ikeda, Akikazu Nakamura, Kenko Azuma, Hiroyuki Akagawa, Jiro Yamamoto, Nobutaka Yamamoto, Takaomi Taira","doi":"10.1159/000546301","DOIUrl":"https://doi.org/10.1159/000546301","url":null,"abstract":"<p><strong>Introduction: </strong>Benign adult familial myoclonus epilepsy (BAFME) is an autosomal dominant disorder characterized by adult-onset cortical tremor and infrequent generalized seizures. Treatment options for managing involuntary movements in BAFME remain limited.</p><p><strong>Case presentation: </strong>Here, we present two cases involving individuals with BAFME who underwent Vim thalamotomy for tremor-like myoclonus. Despite the intervention, neither patient experienced any improvement in their symptoms.</p><p><strong>Conclusion: </strong>These findings suggest that the Vim nucleus may not contribute to the pathophysiology of tremor-like myoclonus in BAFME, despite the established efficacy of Vim thalamotomy in the treatment of essential tremor.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Ultrasound in the Treatment of Epilepsy: Current Applications and Future Directions.","authors":"Benjamin Sterling Succop, Andreas Seas, Joshua Woo, Kevin Jesus Bode Padron, Alyssa M Bartlett, Bhavya Shah, Shruti Agashe, Stephen Harward Ii","doi":"10.1159/000545716","DOIUrl":"https://doi.org/10.1159/000545716","url":null,"abstract":"<p><p>Epilepsy is the fourth most common neurological disorder, affecting nearly 1% of the global population. Despite recent advancements in medical therapies, approximately one-third of patients remain refractory to treatment, necessitating consideration of surgical intervention. Historically, epilepsy surgery has been invasive and maximalist in nature, involving extensive brain resections with significant risk for morbidity. However, emerging approaches offer promising, less-invasive alternatives. One such technique is focused ultrasound (FUS), a rapidly evolving, incisionless, image-guided therapy that allows physicians to precisely target specific brain regions with ultrasonic energy to achieve a range of therapeutic effects. Currently, FUS has been clinically applied for targeted brain ablation (high intensity or HIFU) and neuromodulation (low intensity or LIFU), with recent basic science applications of sonogenetics and targeted drug delivery through the blood brain barrier (Precise Intracerebral Noninvasive Guided, or PING, Surgery) offering new opportunities for clinical translation. This review summarizes pre-clinical and clinical applications of FUS for epilepsy treatment, addresses challenges to implementation, and explores key areas for future research.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-32"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative feasibility and complication analyses of extra-operative (bedside) removal of stereo-electroencephalography (SEEG) electrodes.","authors":"Jiahao J Chen, Thandar Aung, Theodora Constantine, Jorge Alvaro Gonzalez-Martinez","doi":"10.1159/000545984","DOIUrl":"https://doi.org/10.1159/000545984","url":null,"abstract":"<p><strong>Introduction: </strong>Stereotactic electroencephalography (SEEG) involves the implantation of intracortical electrodes for the precise localization of the epileptogenic zone (EZ) and is well-established in terms of its safety and efficacy during implantation-however, there is a notable lack of research comparing different electrode removal techniques, specifically regarding complications and feasibility of these approaches. This study evaluates the feasibility and clinical utility of intraoperative versus extraoperative (bedside) removal of stereotactic-electroencephalography (SEEG) electrodes.</p><p><strong>Methods: </strong>The early feasibility study retrospectively reviewed 117 consecutive SEEG patients at our institution, comparing 101 intraoperative cases with 16 extra-operative cases. A total of 1,624 SEEG electrodes were evaluated. Results related to demographics, feasibility of bedside removal, and occurrence of complications were analyzed and statistically compared between groups.</p><p><strong>Results: </strong>Our findings reveal comparable patient demographics across both groups and demonstrate low complication rates of 1.98% for intraoperative and 0.00% for extra-operative removals, with a combined rate of 1.71%. Importantly, zero cases of infection were observed in both settings. In addition to the low rates of complication in both the intraoperative and extraoperative explant groups, the study indicates a statistically significantly reduced use of sedation in the extra-operative group, which may enhance patient comfort and eliminate the need for additional sedatives during their ongoing treatment. The extraoperative bedside approach also offers practical benefits, such as removing the need for operating room (OR) resources and staffing, which can prevent OR delays and contribute to shorter hospital stays.</p><p><strong>Conclusion: </strong>With the appropriate indications, the extraoperative removal of SEEG electrodes appears to be a feasible and safe alternative to the intraoperative method. It presents potential advantages in optimizing patient flow within epilepsy monitoring units, improving operational efficiency, and potentially reducing healthcare costs while promoting patient comfort. Future research is essential to validate these findings further and refine the bedside technique for broader clinical application.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of robots in epilepsy surgery.","authors":"Matthias Tomschik, Sarina Noelle Somer, Christian Dorfer","doi":"10.1159/000545985","DOIUrl":"https://doi.org/10.1159/000545985","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a prevalent chronic neurological disease affecting millions. Many patients respond to medical therapies, but a third of patients does not and potentially requires neurosurgical procedures. These can be used to localize the onset of seizures and subsequently treat patients. Robotic technologies have emerged over the last decades to increase the efficacy and safety of epilepsy surgery. We therefore wanted to describe the role that robotics in epilepsy surgery have taken since their introduction more than 30 years ago.</p><p><strong>Summary: </strong>Robotic assistance in epilepsy surgery has evolved for more than 30 years. Its earliest use in stereotactic EEG (SEEG) implantations has now also become its most widely used application. Multiple studies have demonstrated that robotic guidance increases the accuracy while also making the implantation of electrodes faster. Beyond diagnostics, robotics have also gained widespread acceptance in ablative neurosurgical procedures where robotic systems improve the placement and can even aid in the finetuning of laser fibers for laser interstitial thermotherapy (LITT). Additionally, robotics have been employed in the placement of electrodes for intracranial neuromodulation therapies in epilepsy such as deep brain stimulation (DBS) and responsive neurostimulation (RNS). Ongoing innovations are further expanding the uses of robotic technologies in epilepsy surgery from aiding in endoscopic procedures to automated craniotomies.</p><p><strong>Key messages: </strong>Robotics in epilepsy surgery have come a long way and have already taken a central role in procedure intended for diagnostic and therapeutic purposes. This narrative review details its many benefits and provides an outlook for future developments.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma Knife Radiosurgery for Glossopharyngeal Neuralgia: A Retrospective Study.","authors":"Andrea Franzini, Piero Picozzi, Zefferino Rossini, Maria Pia Tropeano, Beatrice Claudia Bono, Ali Baram, Pierina Navarria, Federico Pessina","doi":"10.1159/000545986","DOIUrl":"https://doi.org/10.1159/000545986","url":null,"abstract":"<p><strong>Background: </strong>The treatment of patients with glossopharyngeal neuralgia (GN) refractory to medical therapies is challenging. Gamma Knife Radiosurgery (GKRS) has emerged as an incisionless treatment option with outcomes reported in a limited number of studies.</p><p><strong>Objectives: </strong>To report on the outcomes of GKRS in patients with GN treated at our center.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients with GN who underwent GKRS at our center since 2017. Pain intensity was evaluated using the Barrow Neurological Institute (BNI) pain score modified for GN. Adverse events were recorded.</p><p><strong>Results: </strong>Six patients underwent GKRS for GN at our center between 2017 and 2024. The maximum dose delivered was 85Gy for one patient and 90 Gy for the others. After a median period of 2 weeks from GKRS, all patients experienced pain reduction (BNI I-IIIa). Pain recurred during follow-up in two patients after 9 and 3 months, respectively. Both underwent repeat GKRS, which relieved pain in one. No adverse event or neurological deficit occurred.</p><p><strong>Conclusions: </strong>GKRS is an effective, well-tolerated treatment for patients with GN. Pain may recur over time, but more durable pain relief can be achieved with repeat GKRS.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Literature Review on lesion-symptom mapping and Deep Brain Stimulation for poststroke spasticity: Restoring a dysfunctional network?","authors":"Lucien Favre, David Zhang, Claudio Pollo, Andreas Nowacki","doi":"10.1159/000545888","DOIUrl":"10.1159/000545888","url":null,"abstract":"<p><p>Objective The present study aimed to define a structural network of stroke-induced and spasticity-related lesions and to relate this network to target sites and reported effects of Deep Brain Stimulation (DBS) to treat poststroke spasticity. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [1] guidelines were followed. We performed two separate systematic literature reviews collecting data from previously published voxel-based lesion-symptom mapping (VLSM) studies for post-stroke spasticity patients searching the Medline database on Pubmed using the keywords \"stroke\", \"spasticity\", and \"lesion mapping\" as well as data from previously published cohorts undergoing DBS for poststroke spasticity using the keywords \"brain stimulation\" and \"spasticity\". Data collected from each study included patient demographic characteristics, stroke diagnosis, movement disorder, DBS target, stimulation parameters, complications, and outcomes. Data from VLSM studies were used to calculate coordinate-based activation likelihood clusters, which were then used as seeds for enhanced fiber tracking to analyze affected networks. Results Data from five studies on voxel-based lesion-symptom mapping for stroke-induced spasticity were included in the analysis. Metaanalytical mapping of stroke-related lesions identified significant clusters located in the basal ganglia-thalamo-cortical network which were predominantly connected to the sensorimotor cortex. We identified eight studies (four retrospective case series, two prospective open-label non-randomized trials, two prospective double-blind trials) fulfilling our in- and exclusion criteria on DBS for spasticity reporting on 107 patients in total. Most studies reported on outcomes on patients with cerebral palsy (CP), a condition associated with both stroke-related spasticity and hypertonia-related dystonia, which are difficult to differentiate clinically. Target sites included different parts of the cerebellum and the motor thalamus with overall mixed results. Conclusion Because all reported effective DBS target sites are situated along the cerebello-thalamo-cortical network, we hypothesize, that the therapeutic effect of DBS on spasticity might be induced by resetting a functional imbalance between the basal ganglia-thalamo-cortical and the cerebello-thalamo-cortical networks in patients with a supraspinal etiology of spasticity. However, the results need to be interpreted cautiously due to the inevitable inclusion of stroke-related dystonia.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-25"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life after Deep Brain Stimulation: A Primary versus Secondary Dystonia Comparative Study.","authors":"Emily Sanrey, Marylou Grasso, Marie Brethome, Emilie Chan-Seng, Valérie Gil, Philippe Coubes, Gaëtan Poulen","doi":"10.1159/000545755","DOIUrl":"https://doi.org/10.1159/000545755","url":null,"abstract":"<p><strong>Introduction: </strong>Generalized dystonia is a motor disorder causing major limitations in daily living activities. Deep brain stimulation (DBS) is an established therapy for primary disorders, but its efficacy in secondary ones remains variable. Although quality of life (QoL) assessment is crucial in disabling conditions to understand the comprehensive impact of surgical treatment on daily life, the available questionnaires are not well adapted.</p><p><strong>Methods: </strong>Herein, QoL after DBS was evaluated using a \"homemade\" scale. The DBS-QoL scale is a new questionnaire specifically designed for generalized dystonia patients.</p><p><strong>Results: </strong>Twenty-one DYT1 patients and 40 cerebral palsy patients underwent globus pallidus internus DBS during the inclusion period. Clinical improvement was measured using the BFMDRS and compared to QoL evolution using the DBS-QoL. We identified a significant positive impact of DBS on motor and functional aspects for both groups, with superior gains in DYT1 patients. In this group, we found significant improvement in functional aspects, whereas in perinatal hypoxic patients, the opposite trend was reported, with better satisfaction in terms of wellbeing. Across both etiologies, patients expressed satisfaction with the surgical outcomes (83%).</p><p><strong>Conclusion: </strong>QoL assessment, using a dedicated scale, was shown to complement BFMDRS, enhancing the detection of subtle symptom improvements in DBS-treated patients.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of deep brain stimulation and responsive neurostimulation wound complication rates and risk factors: a single-center retrospective study.","authors":"Eric Bayman, Chiagoziem Anigbogu, Ashkaun Razmara, Steven G Ojemann, John A Thompson, Daniel R Kramer","doi":"10.1159/000545146","DOIUrl":"https://doi.org/10.1159/000545146","url":null,"abstract":"<p><strong>Background and objectives: </strong>Deep brain stimulation (DBS) and responsive neural stimulation (RNS) are effective for patients with pharmacoresistant epilepsy. Similar outcomes and increasingly convergent indications means the choice of device may come down to other factors. Common to implanted therapeutic devices, wound associated adverse outcomes are among the more common complications for these two procedures. However, there have been limited studies evaluating the differences in wound complication rates between DBS and RNS, despite the procedural differences for implantation for the two devices. Our objective is to analyze the differences in wound complication rates between patients who received DBS and RNS devices at the University of Colorado Hospital between 2016 and 2023.</p><p><strong>Methods: </strong>All DBS and RNS surgeries performed from 2016 to 2023 for two surgeons at the University of Colorado Hospital were retrospectively reviewed. Wound complications included infection, hardware protrusion, or wound erosion requiring surgical washout, explant, or replacement. Risk factors evaluated included age, sex, diabetes, body mass index, and immunocompromised status. Incidence of complications and risk factors were evaluated and compared using a Chi-squared and Mann-Whitney U test. The relationship between selected risk factors and the probability of wound complication was evaluated using a binomial logistic regression.</p><p><strong>Results: </strong>A total of 297 patients underwent DBS (n=234, n=218 for movement disorders, n=16 for epilepsy) and RNS (n=63) implantation. The DBS group had higher median age at the time of surgery compared to the RNS group (65 vs 37, p<0.001), no other significant differences in group characteristics were noted. Wound complication incidence was greater in the RNS group compared to DBS (12.7% vs 4.3%, p<0.001). No other risk factors were noted to contribute to wound complication rate.</p><p><strong>Conclusion: </strong>Wound complication incidence was greater in RNS patients compared to DBS patients. Differences in age, sex, body mass index, and immunocompromised status were not associated with increased wound complication risk.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudoaneurysm Formation after Stereoencephalography for Epilepsy.","authors":"Henry M Skelton, Nealen G Laxpati, Jason J Lamanna, Faical Isbaine, Daniel L Barrow, Robert E Gross","doi":"10.1159/000543531","DOIUrl":"10.1159/000543531","url":null,"abstract":"<p><strong>Introduction: </strong>Stereoencephalography (SEEG) has emerged as the most common technique for invasive monitoring as part of the preoperative workup for epilepsy surgery. The use of intracranial implants has the potential for vascular injury giving rise to pseudoaneurysm, followed by unpredictable, delayed hemorrhage. Confirmed cases of post-SEEG pseudoaneurysm, as well as suspected cases involving delayed hemorrhage after explanation, are very rare and have not allowed identification of the inciting cause.</p><p><strong>Case presentation: </strong>A patient was evaluated over the course of two SEEG implantations before the decision to proceed with deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) to treat their drug-resistant epilepsy. Preoperative imaging for DBS revealed a pseudoaneurysm proximal to an SEEG craniostomy site. The lesion was treated with excision and vascular bypass, and the patient ultimately underwent DBS as planned. Retrospective analysis strongly implicated the SEEG implantation in pseudoaneurysmal formation, most likely via arterial collision resulting from entry site deviation from the planned stereotactic trajectory.</p><p><strong>Conclusion: </strong>Pseudoaneurysm may be a more prevalent complication of SEEG than existing literature would suggest, as the delayed formation of these lesions can allow them to escape recognition on routine postoperative imaging. Though likely still uncommon, this may suggest the prudence of additional radiological surveillance. This complication is potentially devastating if unrecognized and untreated, but otherwise does not preclude further surgical therapies for epilepsy.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Radiosurgery versus Neuroablative Techniques for Medically Refractory Trigeminal Neuralgia: A Systematic Review and Meta-Analysis of Outcomes.","authors":"Yash Akkara, Jolene Marie Singh, Lewis Thorne, Ciaran Scott Hill","doi":"10.1159/000543859","DOIUrl":"10.1159/000543859","url":null,"abstract":"<p><strong>Introduction: </strong>There is a lack of evidence to guide the choice between stereotactic radiosurgery (SRS) and neuroablative procedures for patients with medically refractory trigeminal neuralgia (TN). This meta-analysis aims to identify the outcomes of these interventions for TN.</p><p><strong>Methods: </strong>Studies identified through PubMed, MEDLINE, and Embase, were cohort studies or clinical trials, had ≥20 participants, and had a ≥12-month follow-up. All participants were ≥16 years old and had primary refractory TN. Studies reported outcomes using the Barrow Neurological Institute (BNI) scale. The Shapiro-Wilk test, Mann-Whitney U test, two-tailed T Test, Spearman's R, and ANCOVA were used to test statistical significance. Screening was done according to PRISMA guidelines. Bias assessment was according to the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>3,288 patients from 37 studies were included (2,537 SRS, 751 neuroablative). Overall reporting of BNI I, II, III, IV, and V was 36.0%, 17.4%, 23.9%, 11.7%, and 10.9%, respectively, in the SRS cohort, and 63.6%, 10.4%, 11.1%, 7.3%, and 7.6%, respectively, in the neuroablative cohort (p < 0.0001). Recurrence was 41.6% in the SRS cohort and 22.5% in the neuroablative cohort (p < 0.001). The neuroablative cohort reported significantly higher rates of hypoesthesia (18.6% vs. 50.5%, p < 0.0001), and minor (19.6% vs. 2.2%, p < 0.0001) and major (3.4% vs. 1.3%, p < 0.001) adverse effects compared to SRS.</p><p><strong>Conclusion: </strong>The findings suggest improved pain relief and reduced recurrence with neuroablative procedures compared to SRS, albeit conferring a higher rate of adverse effects. Neuroablative techniques may be more appropriate for patients with medically refractory TN who are unsuitable for microvascular decompression.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}