Lakshman Vijay Bhaskar, Aal Mahalaxmi, Karumanchi Pradeep Kumar, Jaleel Ayesha, Iyer Aarthi Pashupathy
Department of Radiation Oncology, Health Care Global Enterprises Ltd., Bengaluru, Karnataka, India.
Asian J Neurosurg. 2019 Jul-Sep;14(3):978-980. doi: 10.4103/ajns.AJNS_53_18.
Trigeminal neuralgia caused by vertebrobasilar dolichoectasia is a rare condition. It is characterized by paroxysmal hemifacial pain which is lancinating in type mostly refractory to medical management. This is a report of trigeminal neuralgia secondary to vertebral dolicholectasia refractory to medical management treated with cyber knife stereotactic radiosurgery to the dose of 66 Gy in single fraction to the proximal nerve root. Pain relief was achieved immediately after the treatment and with a follow up period of 2 years, patient is pain free. Cyberknife assisted radiosurgery is relatively safe in delivering high ablative doses with precise conformality to small target regions like proximal nerve root entry of trigeminal nerve with no major toxicities and achieving early pain relief. It is an outpatient and non-invasive procedure. It can be used as a definite treatment modality for trigeminal neuralgia induced by vertebrobasilar dolichoectasia.
椎基底动脉延长扩张症所致的三叉神经痛是一种罕见病症。其特征为阵发性半侧面部疼痛，多为刀割样疼痛，药物治疗大多无效。本文报告了1例药物治疗无效的椎基底动脉延长扩张症继发三叉神经痛患者，采用射波刀立体定向放射外科治疗，单次分割向三叉神经近端神经根给予66 Gy剂量照射。治疗后疼痛立即缓解，随访2年，患者无疼痛。射波刀辅助放射外科在向三叉神经近端神经根等小靶区精确适形地给予高消融剂量时相对安全，无重大毒性反应，并能实现早期疼痛缓解。这是一种门诊非侵入性手术。它可作为椎基底动脉延长扩张症所致三叉神经痛的确定性治疗方式。
