Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Fresh Research - Gamma Knife
        
(Message started by: floridian on Jan 18^th, 2005, 8:40am)

Title: Fresh Research - Gamma Knife
Post by floridian on Jan 18^th, 2005, 8:40am

A study of ten patients who got gamma knife surgery for CH. While some patients showed good or dramatic improvement, many did not. Significant side effects included nerve damage that led to paraesthesia (phantom pain or phantom feelings/idiopathic sensations) or hypoesthesia (loss of sensation/nerve function). The study concluded that current gamma knife techniques are not ready for prime time, and in fact many gamma knife centers stopped using this procedure for CH some time ago.

Quote:

J Neurol Neurosurg Psychiatry. 2005 Feb;76(2):218-221.
Gamma knife treatment for refractory cluster headache: prospective open trial.

Donnet A, Valade D, Regis J. Service de Neurochirurgie, Hopital la Timone, 264 bd Saint Pierre, 13385 Marseille Cedex 05, France. adonnet@AP-HM.fr.

BACKGROUND: Since the initial report of Ford et al in 1998 no further study has evaluated radiosurgery of the trigeminal nerve in chronic cluster headache (CCH). METHODS: We carried out a prospective open trial of neurosurgery and enrolled 10 patients (nine men, one woman; mean age 49.8 years, range 32-77) presenting with severe and drug resistant CCH (mean duration 9 years, range 2-33). The cisternal segment of the nerve was targeted with a single 4 mm collimator (80-85 Gy max). RESULTS: The mean follow up was 13.2 months. No improvement was observed in two patients and three patients had no further attacks. Three patients showed dramatic improvement with a few attacks per month or very few attacks over the last six months. Two patients were pain free for only one and two weeks and their headaches recurred with the same severity as before. Three patients developed paraesthesia with no hypoaesthesia, one developed hypoaesthesia, and one developed deafferentation pain. CONCLUSIONS: The rate and severity of trigeminal nerve injury appeared to be significantly higher than in trigeminal neuralgia, and this study does not support the positive results of the study of Ford et al. We consider the morbidity to be significant for the low rate of pain cessation, making this procedure less attractive even for the more severely affected subgroup of patients.