Journal of Korean Neurosurgical Society
- 제29권5호
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- Pages.650-658
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- 2000
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
특발성 및 이차성 삼차 신경통에 대한 감마나이프 방사선수술의 역할 - 수술적 치료와의 비교 -
The Role of Gamma Knife Radiosurgery for Essential and Secondary Trigeminal Neuralgia - vs Microsurgery -
- 김상현 (경희대학교 의과대학 신경외과학교실) ;
- 임영진 (경희대학교 의과대학 신경외과학교실) ;
- 임언 (경희대학교 의과대학 신경외과학교실) ;
- 이봉암 (경희대학교 의과대학 신경외과학교실) ;
-
고준석
(경희대학교 의과대학 신경외과학교실) ;
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김태성
(경희대학교 의과대학 신경외과학교실) ;
- 김국기 (경희대학교 의과대학 신경외과학교실)
- Keem, Sang Hyun (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Lim, Young Jin (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Leem, Won (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Rhee, Bong Arm (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
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Koh, Jun Seok
(Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
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Kim, Tae Sung
(Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Kim, Gook Ki (Department of Neurosurgery, School of Medicine, Kyung Hee University)
- 투고 : 1999.07.16
- 심사 : 1999.09.27
- 발행 : 2000.05.28
초록
Objective : To evaluate the role of Gamma Knife radiosurgery in essential and tumor-related(secondary) trigeminal neuralgia, outcomes of radiosurgery and microsurgery were compared each other. Methods : Five patients with essential trigeminal neuralgia underwent stereotactic radiosurgical treatment with Leksell Gamma Knife and twenty five patients were treated with microsurgery during the same period(1994. 1-1997. 6). A 4-mm collimator was used and REZ or proximal portion of trigeminal nerve was targeted with maximal dose of 60-72Gy. The mean follow-up after radiosurgery was 39.4 months and that after microsurgery was 47.9 months. Results : At the last follow-up, four patients(80%) had excellent(pain free) or good(50-90% pain relief) outcomes, one(20%) had poor control after radiosurgical treatment. Twenty-three patients(92%) had excellent or good outcomes and two(8%) had poor results after microsurgery. Postoperative complications occurred in ten(40%) with microsurgery, but there were no complications in patients with Gamma Knife radiosurgery. Six patients with secondary trigeminal neuralgia received radiosurgical treatment directed at their tumors, and three patients were surgically treated. Three of six(50%) patients treated with Gamma Knife had pain relief while two of three patients with surgical treatment showed immediate pain relief. Post-treatment complications were developed in two of six radiosurgical patients and in one of three surgical patients. Conclusion : Gamma Knife stereotactic radiosurgery may be considered as a useful and alternative option for the treatment of essential and secondary trigeminal neuralgia owing to of its safety and less complications. The preliminary results obtained in our series appear encouraging, although the outcome is not so good as that of surgery.
키워드