Ağrı tedavisinde gamma knife radyocerrahisinin kullanımı

Radyocerrahi, kafa içindeki küçük hacimli hedeflerin tek dozda yüksek radyasyonla etkilenmesi işlemidir. Ağrı tedavisinde Gamma Knife radyocerrahisi çok uzun yıllardır kullanılmaktadır. Radyocerrahi tekniğinin ilk kullanıldığı olgular trigeminal nevralji hastalarıdır. 1968’de Gamma Knife cihazının kullanıma girmesi ile öncelikle kansere bağlı ağrısı olan hastalarda talamotomi uygulanmıştır. İlerleyen yıllarda başka ağrılı durumlarda da kullanılır olmuştur. Günümüzde en çok trigeminal nevralji tedavisinde kullanılmaktadır.

Anahtar Kelimeler:

Nörocerrahi işlemleri, Radyocerrahi, Ağrı, Stereotaksik teknikler

Gamma knife radiosurgery for treatment of pain

Radiosurgery is to irradiate the small volume targets inside of the cranium with high dose radiation in a single session. Gamma knife radiosurgery has been in use for treatment of pain many years. The first cases which have been treated with radiosurgery technique were trigeminal neuralgia patients. After the first installment of gamma knife in 1968, it has been used for thalamotomy in cancer pain. Nowadays the main indication for gamma knife radiosurgery for pain is trigeminal neuralgia.

Keywords:

Neurosurgical Procedures, Radiosurgery, Pain, Stereotaxic Techniques,

PDF

___

Backlund EO: Gamma hypophysectomy. J Neurosurg. 2004; 100: 1133-1134.
Hayashi M, Taira T, Chernov M et al: Gamma knife surgery for cancer pain- pituitary gland- stalk ablation: a multicenter prospective protocol since 2002. J Neurosurg 2002; Suppl 5, 97; 433-437.
Kondziolka D, Lacomis D, Niranjan A et al: Histological effects of trigeminal nerve radiosurgery in primate model: implications for trigeminal neuralgia radiosurgery. Neurosurgery 2000; 46:971–977.
Kondziolka D, Lunsford LD, Flickinger JC et al: Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit. J Neurosurg 1996; 84: 940-945.
Leksell L: Stereotaxic radiosurgery in trigeminal neuralgia. Acta Chir Scand 1971; 137: 311-314.
Lindquist C, Kihlstrom L, Hellstrand E: Functional neurosurgery: a future for gamma knife? Stereotact Funct Neurosurg 1991; 57: 72-81.
Love S, Hilton DA, Coakham HB: Central demyelination of the Vth nerve root in trigeminal neuralgia associated with vascular compression. Brain Pathol 1998; 8: 1-11.
Maesawa S, Salame C, Flickinger JC et al: Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 2001; 94: 14-20.
Peker S: Radyocerrahi. In: Aksoy K; Ed. Temel Nöroflirürji. Ankara; 2005: 836-844.
Pollock BE, Phuong LK, Gorman DA et al: Stereotactic radiosurgery for idiopathic tr, geminal neuralgia. J Neurosurg 2002; 97: 347-353.
Pollock BE, Kondziolka D: Stereotactic radiosurgical treatment of sphenopalatine neuralgia. J Neurosurg 1997; 87: 450-453
Rand RW, Jacques DB, Melbye RW et al: Leksell gamma knife treatment of tic douloureux. Stereotact Funct Neurosurg 1993; 61 Suppl 1: 93-102
Tew JM, Martens J, VanLoveren H, Taha J: Efficacy and morbidity of Linac-based stereotactic radiosurgery for the treatment of trigeminal neuralgia. In: Proceedings of the 3rd National Trigeminal Neuralgia Conference; Oct 26-29, 2000; Pittsburgh; 2000. p.16.
Steiber VW, Bourland JD, Ellis TL: Glossopharyngeal neuralgia treated with gamma knife surgery: treatment outcome and failure analysis. J Neurosurg 2005; (Suppl) 102: 155-157
Steiner L, Forster D, Leksell L et al: Gammathalamotomy in intractable pain. Acta Neurochir 1980; 52: 173-184.
Young RF, Jacques DS, Rand RW et al: Medial thalamotomy with the leksell gamma knife for treatment of chronic pain. Acta Neurochir 1994; 62: 105-110.