Treatment of trigeminal neuralgia by thermocoagulation, glycerolization, and percutaneous compression of the gasserian ganglion and/or retrogasserian rootlets: Long-term results and therapeutic protocol

B. Fraioli, V. Esposito, B. Guidetti, G. Cruccu, M. Manfredi

Research output: Contribution to journalArticle

Abstract

From 1976 to 1986, 681 patients with drug-refractory trigeminal neuralgia (TN) - typical in 641, symptomatic of multiple sclerosis in 23 and of tumor in 10, atypical in 5, and postherpetic in 2 - were treated with various percutaneous procedures. Controlled differential thermocoagulation of the gasserian ganglion and/or retrogasserian rootlets was performed in 533 patients; glycerolization of the trigeminal cistern in 32; and compression of the gasserian ganglion by balloon catheter in 159. Results and complications of each procedure are assessed at a mean follow-up of 6.5 years for thermocoagulation, 5 years for glycerolization, and 3.5 years for compression. The following therapeutic protocol is proposed: 1) in TN patients at first operation: a) gasserian compression (or glycerolization, if experience warrants it) is indicated in all cases of typical TN, unless the 3rd division alone is affected; b) in the latter case and in symptomatic TN, we suggested thermocoagulation; 2) in recurrences: a) after glycerolization of gasserian compression, gasserian compression (or glycerolization) is indiated; b) after thermocoagulation or open surgery, thermocoagulation is suggested.

Original languageEnglish
Pages (from-to)239-245
Number of pages7
JournalNeurosurgery
Volume24
Issue number2
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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