Radiosurgery for trigeminal neuralgia

Abstract

Radiosurgery is a relatively novel technique in the armamentarium of TN treatment. Since 50% of the patients eventually require a surgical procedure to alleviate pain, the appropriate selection of patients to the different surgical techniques is a question of utmost relevance. The systematic literature reviews and the largest peer reviewed publications on the surgical treatment series of refractory trigeminal neuralgia are discussed considering the pros and cons of each surgical technique. Protocol variations and results of modern peer reviewed radiosurgery series are presented with focus on radiation doses and targets, aiming to maximize the understanding of the technique. Further well designed randomized trials focusing on the determination of the ideal target and radiation dose can optimize radiosurgery results, aiming to achieve the level of the results obtained with microvascular decompression, currently considered the gold-standard method.