Gamma Knife Treatment of Refractory Cluster Headache

Ford, Robert G.; Ford, Kay T.; Swaid, Swaid; Young, Paul E.; Jennelle, R.

doi:10.1046/j.1526-4610.1998.3801003.x

Cited by 70 publications

(42 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Gamma knife radiosurgery of the trigeminal nerve root entry zone has been reported in 5 chronic CH patients with neglible short-term and long-term sequelae (Ford et al 1998). …”

Section: Destructive Proceduresmentioning

confidence: 99%

Surgical Interventions for Cluster Headache, Including Implanted Stimulators

Paemeleire

Marteletti

2011

Handbook of Headache

View full text Add to dashboard Cite

“…Gamma knife radiosurgery of the trigeminal nerve root entry zone has been reported in 5 chronic CH patients with neglible short-term and long-term sequelae (Ford et al 1998). …”

Section: Destructive Proceduresmentioning

confidence: 99%

Surgical Interventions for Cluster Headache, Including Implanted Stimulators

Paemeleire

Marteletti

2011

Handbook of Headache

View full text Add to dashboard Cite

“…Gamma knife SRS has been proposed as a minimally invasive alternative management option for CH (Table 1) [4,[30][31][32][33]. Ford et al [32] reported six refractory CH patients, four of whom achieved excellent pain relief, one good pain relief, and one fair pain relief days to weeks after SRS.…”

Section: Stereotactic Radiosurgery For Cluster Headachementioning

confidence: 99%

“…Ford et al [32] reported six refractory CH patients, four of whom achieved excellent pain relief, one good pain relief, and one fair pain relief days to weeks after SRS. No patient had significant side effects when studied 8 to 14 months afterwards.…”

Section: Stereotactic Radiosurgery For Cluster Headachementioning

confidence: 99%

Gamma Knife Stereotactic Radiosurgery in the Management of Cluster Headache

Kano

Kondziolka

Niranjan

et al. 2010

Curr Pain Headache Rep

View full text Add to dashboard Cite

Gamma knife stereotactic radiosurgery (SRS) has proven to be an effective management approach for trigeminal neuralgia and as a minimally invasive alternative management option for cluster headache (CH). In CH, patients undergo single-session focused irradiation of the trigeminal nerve root (TN), sometimes coupled with irradiation of the sphenopalatine ganglion (SPG) as well. SRS provides early pain relief in most patients, but is associated with trigeminal sensory dysfunction in some patients. In the future, a prospective trial that compares a single target of TN to dual targets of both the TN and SPG may provide further understanding of the value of SRS for CH.

show abstract

“…Previously used approaches have included trigeminal ganglion glycerol injections, 10,11 radiofrequency rhizotomy of the Gasserian ganglion 12 or gamma knife aimed at the trigeminal nerve, 13,14 microvascular decompression 15 and esection or blockade of the N. petrosus superficialis 16 or pterygopalatine (sphenopalatine) ganglion. [17][18][19] There are case series of trigeminal nerve root section to the episodic form, 23 so a procedure should not be less safe than the natural history.…”

Section: What Approaches Have Been Tried?mentioning

confidence: 99%

Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache

May¹,

Goadsby²

2010

European Neurological Review

View full text Add to dashboard Cite

Cluster headache (CH) is, by neurological standards, a relatively common condition that affects about one in 1,000 people, 1 although compared with other more common primary headaches such as migraine 2 it remains rare in practice. CH has been defined in the second edition of the International Classification of Headache Disorders 3 as involving recurrent attacks of severe pain on one side of the head for between 15 and 180 minutes, associated with cranial autonomic features such as lacrimation, conjunctival injection, nasal congestion or rhinnorhoea (see Table 1). This condition can be divided into episodic (ECH) and chronic (CCH) forms. A diagnosis of ECH requires at least two cluster periods lasting from seven days to one year separated by painfree periods lasting one month or longer, while a diagnosis of CCH requires attacks to occur for more than one year without remission or with remission lasting less than one month. CCH affects about 10% of CH patients. General aspects of therapy of the disorder are covered elsewhere. 4,5 While it is not directly germane to neuromodulatiuon approaches, an understanding of the broad issues in medical treatment serves as a useful backdrop against which to discuss newer approaches. CH is one of the trigeminal autonomic cephalalgias, 6 and their therapies are usefully considered to be background 7 as they also can be considered for these newer approaches. Who Is Suitable for Neuromodulation Approaches?It seems reasonable to suggest that neuromodulation approaches to the management of CH be employed in patients with medically intractable forms of the condition. While this is currently true, it reflects the relatively primitive state of current interventions. One should observe that as devices become less invasive, the threshold for their use will become lower. For the moment there is a proposed working definition of medically intractable CH. 8 The essential components are disabling headache that fails at least four preventative drugs, including two from the first three of verapamil, lithium, methysergide, melatonin, topiramate and gabapentin (see Table 2). These considerations are particular to CH and, naturally, generic considerations related to requirements for the devices -such as fitness for anesthesia -are part of the overall assessment of patient suitability. What Approaches Have Been Tried?In essence, two classes of neuromodulation have been explored in CH:peripheral and central. Prior to moving to stimulation approaches, the dreadful pain and disability of medically intractable CH lead to a number of destructive procedures. In principle, these seem unlikely to work if one considers CH as fundamentally being a brain condition. Moreover, they may cause both mortality and significant morbidity, and can induce further pain problems such as anaesthesia dolorosa. Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache AbstractThe trigeminal autonomic cephalalgias are a group of primary headache disorders characterised by unilateral trigeminal d...

show abstract

Gamma Knife Treatment of Refractory Cluster Headache

Cited by 70 publications

References 1 publication

Surgical Interventions for Cluster Headache, Including Implanted Stimulators

Surgical Interventions for Cluster Headache, Including Implanted Stimulators

Gamma Knife Stereotactic Radiosurgery in the Management of Cluster Headache

Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache

Contact Info

Product

Resources

About