Focal Enhancement of Cranial Nerve V after Radiosurgery with the Leksell Gamma Knife: Experience in 15 Patients with Medically Refractory Trigeminal Neuralgia
Ronald A. Albericoa,
Robert A. Fenstermakera and
Jeffery Lobela
a From the Departments of Diagnostic Radiology (R.A.A.) and Neurosurgery (R.A.F., J.L.), Roswell Park Cancer Institute, Buffalo, NY.
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FIG 1. Nine of 10 enhancing cranial nerves had a qualitative score of 3.
A, Nonenhanced T1-weighted MR image (400/11/2) in an 88-year-old man with trigeminal neuralgia on the left, obtained 78 d after gamma knife radiosurgery. An excellent response to treatment was achieved. Treatment dose was 45 Gy to the 50% isodose line. Note the intensity of cranial nerve V (arrow).
B, Contrast-enhanced T1-weighted MR image (400/11/2) of cranial nerve V shows marked (grade 3) focal enhancement of the nerve (arrow) adjacent to the pontine edge.
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FIG 2. One of 10 enhancing cranial nerves had a qualitative score of 2.
A, Nonenhanced T1-weighted MR image (400/11/2) in a 74-year-old woman with trigeminal neuralgia, obtained 54 d after treatment with gamma knife radiosurgery. Treatment resulted in a poor response. Treatment dose was 35 Gy to the 50% isodose line. Cranial nerve V (arrow) is well depicted.
B, Contrast-enhanced T1-weighted MR image (400/11/2) shows subtle (grade 2) enhancement of cranial nerve V (arrow).
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