Patients with multiple sclerosis (MS) are more likely to develop trigeminal neuralgia (TN) compared to the regular population, due to scarring of the nerve and development of a demyelination plaque. ...Despite treatment, approximately 10% of MS patients treated for TN experience symptom recurrence, including the development of MS-like symptoms such as optic neuritis and bilateral facial pain.
A computed tomography (CT) scan was performed preoperatively on two patients diagnosed with multiple sclerosis (MS) who experienced secondary trigeminal neuralgia (TN). A precise reference frame was strapped firmly to the patient's forehead during the intraoperative procedure. Preliminary CT images were registered using the navigation system and the bony landmarks were set.
Two patients diagnosed with multiple sclerosis (MS) who experienced refractory trigeminal neuralgia (TN) underwent percutaneous balloon compression. Initial conservative treatment and one dosage of Gamma Knife Radiosurgery (GKR) resulted in symptom control for a few weeks. Both patients had an acute recurrence of pain; thus, percutaneous retrogasserian balloon compression was performed. During follow-up, the patients reported a 70% decrease in pain after the procedure, with minimal recurrence of shooting episodes.
Management of trigeminal neuralgia secondary to drug-resistant multiple sclerosis presents a persistent challenge. The percutaneous technique for retrogasserian balloon compression may offer a solution for some patients, but it presents unique challenges for neurosurgeons. Given the complexity of the pathogenesis, target identification, and the potential absence of neurovascular conflict, microvascular decompression remains a debated approach for this patient population. While stereotactic radiosurgery may be a promising alternative.
•Frame navigation ensures accurate identification of trigeminal nerve.•Percutaneous balloon compression minimizes invasiveness, expediting recovery.•Effective pain relief from refractory secondary trigeminal neuralgia.•Surgical treatment enhances quality of life, reducing complications.•Frame navigation enables customized strategies based on individual anatomy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Gamma knife radiosurgery (GKRS), a form of stereotactic radiosurgery (SRS), has gained importance in treating glioblastoma alongside conventional chemotherapy. This study aims to assess the efficacy ...of combining GKRS with surgery and chemotherapy to enhance treatment outcomes for glioblastoma patients. This prospective clinical study, adhering to STROBE guidelines, assessed 121 glioblastoma patients from June 2008 to December 2022. All patients who had not undergone prior radiotherapy underwent open surgical tumor resection, GKRS, and adjuvant chemotherapy. In the analyzed cohort, the median survival post-diagnosis was 21.2 months (95% CI: 11.4–26.7) and the median progression-free survival was 13.6 months (95% CI: 12.5–28.3). The median time to first recurrence post-treatment was 14.5 months (range: 4–33 months). The median prescribed dose for GKRS was 12 Gy (range: 10–17 Gy), with a median target volume of 6.0 cm3 (range: 1.6–68 cm3). Post GKRS, 92 patients experienced local recurrence, 21 experienced distant recurrence, and 87 received additional treatment, indicating diverse responses and treatment engagement. This study evaluates the use of GKRS for glioblastomas, emphasizing its efficacy and complications in a single-center trial. It suggests integrating GKRS into initial treatment and for recurrences, highlighting the comparable survival rates but underscoring the need for further research.
Introduction: The Sacroiliac joint (SIJ) is a crucial connection found between the sacrum and ilium. It plays a vital role in transferring forces during physical activity, such as running. Its ...biomechanical function is crucial for ensuring stability, as it is supported by ligaments and pelvic floor muscles that work together to ensure this for individuals. However, SIJ dysfunction can be linked to lower back pain, which is a condition that affects around 70-85% of Western society. Causes: SIJ dysfunction originates from various factors, such as abnormal motion or malalignment. These conditions can arise from multiple causes: arthritis, trauma, or nontypical gait patterns. Diagnosis: Physical examinations are included in the diagnosis of SIJ dysfunction. They are called FABER, compression, distraction, thigh thrust, and Gaenslen. Three provocative test results are oftentimes required for a diagnosis. Other methods of diagnosis are also used, like X-rays, MRIs, and joint injections. Misdiagnosis: Nevertheless, although multiple methods exist to diagnose SIJ dysfunction, it is very commonly misdiagnosed. This is because the condition mimics symptoms of other conditions, and its etiology is overlooked. Treatment: When diagnosed, SIJ dysfunction can be treated through a range of measures. Either conservative treatments can be done, like physical therapy and NSAIDs, or more invasive procedures, such as surgical interventions, can be used to treat SIJ dysfunction. Conclusion: SIJ dysfunction is a prevalent, misdiagnosed condition that affects many individuals. This review highlights the importance of raising awareness among the public and clinicians to ensure an accurate diagnosis and treatment is given to patients.
