Stereotactic and Functional Neurosurgery最新文献

{"title":"Frailty Indices in Patients Undergoing Functional Neurosurgical Procedures: A Systematic Review.","authors":"Carmelo Venero, Joanna M Roy, Nirbha Ghurye, Akshay Warrier, Muhammad Usman Khalid, Niels Pacheco-Barrios, Farhan A Mirza, Christian A Bowers","doi":"10.1159/000547128","DOIUrl":"https://doi.org/10.1159/000547128","url":null,"abstract":"<p><strong>Introduction: </strong>Functional neurosurgery covers a wide array of neurological disorders with an equally vast array of treatment modalities, including neuromodulation, decompressive, &amp; ablative therapies for disparate pathologies such as pain, neuromodulation, disconnection, and refractory epilepsy. One of the most common functional treatments is deep brain stimulation for movement disorders and select psychiatric diseases. Functional neurosurgery treats patients with reduced quality of life from pathological neuronal pathways. Optimal patient selection by preoperatively identifying high risk patients is critical for avoiding as many operative complications as possible, in addition to managing complications better once they occur. Frailty indices have demonstrated superior discrimination in predicting adverse postoperative outcomes across the spectrum of neurosurgical subspecialties when compared to increasing patient age. This systematic review describes multiple different frailty indices utilized by patients undergoing functional neurosurgery procedures.</p><p><strong>Methods: </strong>A systematic review of literature was performed using PubMed. The Newcastle Ottawa Scale (NOS) was used to assess for risk of bias and studies with NOS > 6 were considered high quality. An initial search identified 541 articles through our search strategy and, after screening and review, five met criteria for inclusion The 5-factor modified frailty index (mFI-5) and Risk Analysis Index (RAI) were most frequently utilized (n = 5). One study utilized single-hospital databases in contrast to the nationwide databases utilized by the other four studies.</p><p><strong>Results: </strong>RAI was found to have superior predictive ability as frailty metric when compared to the mFI-5. All five studies were considered high-quality based on the NOS. Frailty indices have demonstrated the ability to predict adverse outcomes in patients undergoing procedures from across the spectrum of neurosurgical subspecialties.</p><p><strong>Conclusion: </strong>Our review identified articles that utilized frailty indices in predicting outcomes among patients undergoing functional neurosurgery procedures.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-16"},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554917","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":"Structural connectivity of the basal ganglia from patient-individual tractography is key for understanding the effects of deep brain stimulation in Parkinson's Disease.","authors":"Ricardo Loução, Martin Kocher, Gregor Alexander Brandt, Jan Niklas Petry-Schmelzer, Michael Barbe, Haidar Dafsari, Josef Mana, Robert Jech, Jochen Wirths, Veerle Visser-Vandewalle, Pablo Andrade, Halim Baqapuri, Michael Luehrs, David E J Linden, Brendan Santyr, Andres Lozano, Alessandro Bongioanni, Bechir Jarraya, Tolga Cukur","doi":"10.1159/000546716","DOIUrl":"https://doi.org/10.1159/000546716","url":null,"abstract":"<p><strong>Background: </strong>In Parkinson's disease (PD) patients, modulation of the fibre tracts of the cortico-basal ganglia-thalamo-cortical loop is the presumed mechanism of action of deep brain stimulation (DBS) of the subthalamic nucleus (STN). Therefore, we explored patient-individual cortical structural connectivity of the volume of tissue activated (VTA), as well as DBS-induced modulation of fibre tracts connecting the STN with cortical and subcortical nodes, and their correlation with therapeutic effects.</p><p><strong>Patients and methods: </strong>A retrospective cohort of n = 69 PD patients treated with bilateral DBS of the STN was analysed. Clinical response was assessed from the DBS-induced change in the UPDRS-III motor scores (total and symptom-specific sub-scores) under regular medication after a median follow-up of 9.0 (range 2.6 - 20.2) months. Tractography based on patient-individual diffusion-weighted MRI was employed in two ways. Whole brain tractography was used to identify the cortical connections of fibres passing the VTAs, and reconstruction of specific white matter pathways of the motor loop connecting the STN with the basal ganglia and cortex were used to identify the proportion of fibres within these pathways which was modulated by STN-DBS. This proportion of pathway modulation was used in a correlative analysis with clinical outcomes.</p><p><strong>Results: </strong>Fibres traversing the VTAs were primarily connected to the supplementary motor area (SMA) and to a lesser degree to the premotor cortex. Within the pathways connecting the STN with the cortical and subcortical nodes, on average 30-40% (range 10-80%) of the fibres were modulated by STN-DBS. This proportion correlated significantly with the percentage change in UPDRS motor score for fibres connecting the STN with the SMA (ρ=0.28), pre-SMA (ρ=0.26), ventral and dorsal pre-motor cortices (ρ=0.26 and ρ=0.29, respectively), and the globus pallidus externus (GPe, ρ=0.26) and internus (GPi, ρ=0.29). Also, good clinical responses for both tremor and rigidity were associated with a significantly (p < 0.05) higher proportion of modulated fibres for the same cortico- and sub-cortico-STN connections.</p><p><strong>Conclusions: </strong>Patient-individual tractography reveals that, in PD, most of the cortical fibres traversing the VTA are connected to the SMA. In addition, clinical efficacy is related to the proportion of DBS-affected fibres connecting the STN with nodes of both the hyperdirect (cortex-STN) and the indirect pathways (STN-basal ganglia). As such, patient-specific tractography, in particular in the basal ganglia, could be used in a clinical context as a tool to guide therapy.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-29"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326892","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":"MRI-guided Focused Ultrasound VIM Thalamotomy with Indwelling GPi DBS Electrodes: A Case Report.","authors":"Adam C Glaser, David D Liu, P Jason White, Emily A Ferenczi, Albert Y Hung, Nathan J McDannold, G Rees Cosgrove","doi":"10.1159/000546737","DOIUrl":"https://doi.org/10.1159/000546737","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) is the gold-standard surgical treatment for Essential Tremor (ET) and Tremor-dominant Parkinson's Disease (TdPD). However, despite appropriate electrode placement and programming, patients may develop tremor recurrence due to disease progression. MRI-guided focused ultrasound (MRgFUS) thalamotomy is an alternative treatment to DBS and has been shown to yield durable tremor control in both ET and TdPD patients. However, MRgFUS thalamotomy in a patient with indwelling DBS electrodes has not been previously reported.</p><p><strong>Case presentation: </strong>We present the case of a 77-year-old male with progressive TdPD who underwent bilateral globus pallidus internus (GPi) DBS with subsequent right unilateral VIM thalamotomy 23 months after DBS due to progressive tremor recurrence. At 6 month follow up, his tremor has completely resolved.</p><p><strong>Discussion: </strong>This is the first report of MRgFUS thalamotomy for recurrent tremor with indwelling DBS electrodes. We found that MRgFUS thalamotomy as salvage therapy with implanted GPi DBS electrodes is both safe and effective. It represents a novel potential treatment paradigm for TdPD patients with persistent tremor despite otherwise effective GPi DBS.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310398","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":"Managing LEATs in Patients with Refractory and Non-Refractory Epilepsy.","authors":"Arjun Rohit Adapa, Hannah Haile, Guy M McKhann","doi":"10.1159/000546652","DOIUrl":"https://doi.org/10.1159/000546652","url":null,"abstract":"<p><p>Background Long-term/low grade epilepsy-associated tumors (LEATs) compose a complex group of low-grade brain neoplasms associated with drug-resistant focal epilepsy, primarily affecting pediatric and adolescent populations. LEATs exhibit significant epileptogenic potential, profoundly impacting patients' neurological and psychosocial outcomes. Advances in molecular pathology, particularly the identification of BRAF V600E and FGFR1 mutations, have enhanced the classification and understanding of these tumors, opening potential avenues for targeted therapies. Summary This review synthesizes current knowledge on LEAT biology, epileptogenesis, and clinical manifestations, highlighting the tumor microenvironment's role in seizure generation through disrupted neurotransmitter signaling, inflammatory processes, and network hyperexcitability. The integration of advanced neuroimaging, electrophysiology, and molecular diagnostics has refined LEAT detection and classification, improving surgical decision-making. Surgical resection remains the mainstay of treatment, with seizure freedom rates exceeding 80% when combined with tailored epilepsy surgery. However, variability in surgical outcomes underscores the need for individualized approaches, incorporating emerging minimally invasive techniques, such as laser interstitial thermal therapy (LITT), and neuromodulation strategies. Key Messages Despite advancements in the diagnosis and treatment of LEATs, key challenges remain, including refractory epilepsy, malignant progression, and the long-term impact of LEATs on cognitive function. Future research aims to refine the molecular and histopathological classification of LEATs, develop predictive biomarkers for seizure outcomes, and explore precision therapies targeting tumor-associated epileptogenesis. As the field evolves, a multidisciplinary approach integrating surgery, molecular therapeutics, and neurorehabilitation will be essential in optimizing patient outcomes.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-29"},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286529","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 Study Evaluating a New Dose Optimization Software for Gamma Knife Treatment Planning: Comparison of 80 Challenging Treatment Plans.","authors":"Lucie Hamáčková, Josef Novotný, Markéta Farníková, Roman Liščák, Gabriela Šimonová, Dušan Urgošík, Michal Schmitt","doi":"10.1159/000546214","DOIUrl":"10.1159/000546214","url":null,"abstract":"<p><strong>Introduction: </strong>In 2020, Elekta Instrument AB, Stockholm, released a new dose optimizer for Leksell GammaPlan, which includes the possibility of inverse planning. This study aimed to compare the new software with the previous manual version of treatment planning for stereotactic radiosurgery and evaluate its performance.</p><p><strong>Materials and methods: </strong>Four types of diagnoses - vestibular schwannomas, pituitary adenomas, meningiomas, and single brain metastasis - along with 80 clinically approved challenging cases, were selected for testing the new software. Key parameters, including coverage, selectivity, target volume, and doses to critical structures, were collected and statistically analysed using a t test. These parameters were compared based on the Leksell Gamma Knife (LGK) Society standardization document for stereotactic radiosurgery, both for each diagnosis and for the entire dataset.</p><p><strong>Results: </strong>The new software showed a clear advantage, particularly in sparing critical structures while maintaining or improving treatment plan conformity. Doses to critical structures such as the optic nerve, brainstem, cochlea, and pituitary gland decreased by an average of 13% (0.76 Gy), 7% (0.52 Gy), 7% (0.2 Gy), and 14% (1.04 Gy), respectively, reducing toxicity. Other plan parameters also showed significant improvements, except for the gradient index. Selectivity improved by 11% (0.03), the Shaw Conformity Index improved by 10% (0.1), and coverage improved by 0.01. Additionally, treatment time was reduced by 10% enhancing patient comfort.</p><p><strong>Conclusion: </strong>Overall, LGK Lightning is faster and produces treatment plans with superior parameters compared to manual planning.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175039","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":"Battery Longevity in Deep Brain Stimulation for Parkinson's Disease.","authors":"Forough Yazdanian, Alejandro Enriquez-Marulanda, Nima Dehmamy, Ali Mortezaei, Taimur Hassan, Jay L Shils, Ron L Alterman","doi":"10.1159/000544714","DOIUrl":"10.1159/000544714","url":null,"abstract":"<p><strong>Introduction: </strong>In patients receiving deep brain stimulation (DBS) therapy, the longevity of the implanted pulse generator (IPG) is influenced by multiple factors, including patient diagnosis, therapeutic target, neurostimulator type, number of implanted leads, and stimulation settings. Recent advancements in DBS technology include longer-lived batteries, both standard and rechargeable. This study assessed the estimated IPG longevity of Medtronic, Inc., Percept™ PC neurostimulator in Parkinson's disease (PD) and explores factors associated with IPG lifespan.</p><p><strong>Methods: </strong>Retrospective analysis of Percept™ devices in 31 PD patients who underwent bilateral DBS targeting either the internal globus pallidus or the subthalamic nucleus (STN). The analysis included demographics, clinical information, stimulation settings, lead locations, and total effective energy delivered (TEED).</p><p><strong>Results: </strong>The median IPG longevity was 75.9 months (51.6-92.3). Among stimulation parameters, frequency demonstrated the strongest inverse correlation with longevity (r = -0.49, p < 0.01), followed by pulse width (r = -0.39, p < 0.01), TEED (r = -0.35, p < 0.01), current amplitude (r = -0.33, p < 0.01), and voltage (r = -0.25, p = 0.04), regardless of laterality. In STN-targeted patients, a significant association was observed between the Z-coordinate of the right lead and the presence of side effects (p = 0.04). Monopolar stimulation on the dominant side showed significantly longer IPG longevity compared to bipolar stimulation (80.6 vs. 49.6 months, p = 0.01).</p><p><strong>Conclusion: </strong>Significant negative correlations were observed between longevity and various stimulation parameters regardless of laterality. Monopolar stimulation on the dominant side was associated with increased longevity.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102741","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":"Lack of Therapeutic Benefit of Ventral Intermediate Nucleus 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":"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 2 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 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":"1-5"},"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":"Comparative Feasibility and Complication Analyses of Extraoperative (Bedside) Removal of Stereo-Electroencephalography Electrodes.","authors":"Jiahao J Chen, Thandar Aung, Theodora Constantine, Jorge Alvaro Gonzalez-Martinez","doi":"10.1159/000545984","DOIUrl":"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 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 extraoperative 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 extraoperative 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 extraoperative 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":"1-10"},"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":"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 fine-tuning of laser fibers for laser interstitial thermotherapy. Additionally, robotics has been employed in the placement of electrodes for intracranial neuromodulation therapies in epilepsy such as deep brain stimulation and responsive neurostimulation. 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 has come a long way and has 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":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148316/pdf/","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":"OA","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":"10.1159/000545986","url":null,"abstract":"<p><strong>Introduction: </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. The aim of this study was 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 85 Gy for 1 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 2 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":"1-8"},"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}