Would you recommend upfront radiosurgery for trigeminal neuralgia caused by AVM abutment at the entry root zone?
If not, then what is your preferred treatment and would you integrate SRS into it?
Answer from: Radiation Oncologist at Academic Institution
Radiosurgery (SRS) at high doses to the dorsal nerve root entry zone is an effective treatment modality for primary or idiopathic trigeminal neuralgia (TN), but is significantly less efficacious when utilized for secondary trigeminal neuralgia, as caused by tumors, plaques, AVMs, etc. There are case...
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Answer from: Radiation Oncologist at Community Practice
I believe the optimal treatment regimen in this complex clinical situation requires reflection on the nuances not just of available treatments for trigeminal neuralgia and arteriovenous malformation but also the relative risks of each. In addition to managing the patient's pain, important considerat...
Answer from: Radiation Oncologist at Academic Institution
I concur with Dr. @Minesh P. Mehta. The beauty of this approach, treating the AVM and not the REZ of the 5th nerve, is that the dose of RT needed to occlude an AVM is much smaller (usually 18-21Gy) than the dose necessary to achieve remission of pain from primary Trigeminal Neuralgia (usually 90 Gy ...