101
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Manning M, Mark R, Anderson P, Akins R, Nair M. Previous Transurethral Resection of the Prostate (TURP) is Not a Contraindication for Interstitial High Dose Rate (HDR) Brachytherapy for Prostate Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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102
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Nair M, Thompson B, Mulik V, Shaw J, Karunakaran B. O657 Management of idiopathic polyhydramnios. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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103
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Thompson R, Grossmith A, Mulik V, Nair M. P151 The effect of Body Mass Index (BMI) on sibling birth weight. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61642-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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104
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Grossmith A, Nair M, Mulik V. P18 Observational study on the use of parenteral iron treatment for anaemia in pregnancy and the immediate post-partum period. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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105
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Abstract
There have been significant advances in our understanding of the aetiology and management of disorders specific to Monochorionic Diamniotic (MCDA) twin pregnancies like Twin-Twin Transfusion Syndrome (TTTS) and Twin Reversed Arterial Perfusion (TRAP) but there is paucity of data about the management of uncomplicated MCDA twins pregnancies. It is accepted that even in the absence of specific complications, these pregnancies are associated with increased perinatal morbidity & mortality. The aim of this review is to gather evidence regarding the management of seemingly uncomplicated monochorionic diamniotic pregnancies.
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106
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107
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Nair M, Mark R, Anderson P, White M, Ho Y, Banwo B, Nair S. SU-FF-T-78: High Dose Rate Interstitial Brachytherapy (HDRIB) for Localized Breast Cancer: New Plan Evaluation Criteria. Med Phys 2009. [DOI: 10.1118/1.3181551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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108
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Balaji R, Ramachandran K, Nair M, Kusumakumari P. Chemotherapy-Induced Posterior Reversible Encephalopathy Syndrome in Childhood Chronic Myeloid Leukemia. Neuroradiol J 2009; 22:204-8. [DOI: 10.1177/197140090902200211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 03/21/2009] [Indexed: 11/16/2022] Open
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological phenomenon seen in a wide spectrum of clinical conditions and is characterized clinically by headache, altered mental status, visual loss and seizures and reversible neuroimaging findings. This study evaluated MR imaging in PRES in a clinical oncology setting. MR findings may be helpful in disclosing the underlying pathophysiological mechanisms of the syndrome. The MR imaging protocol consisted of T2–weighted, fluid attenuation inversion recovery (FLAIR), diffusion weighting imaging (DWI) and apparent diffusion coefficient (ADC) sequences. Contrast enhanced computed tomography (CT) of the brain revealed bilateral symmetric subcortical hypodense lesions in the parieto-occipital regions. T2–weighted and FLAIR sequences showed bilateral, symmetrical focal cortical and subcortical hyperintensities involving the parietal and occipital lobes. These areas appeared hyperintense on DWI while the ADC (Apparent Diffusion Coefficient) maps demonstrated higher apparent diffusion coefficients in areas of FLAIR abnormalities thus confirming vasogenic edema. Follow-up scan five days later showed improvement or resolution of the abnormalities. Transient DWI hyperintensities seen in cortical watershed areas corresponding to the hyperintense foci in FLAIR imaging are suggestive of foci of vasogenic edema secondary to vasospasm in highly ischemia-sensitive cerebral tissue.
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109
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Colenda J, Mark R, Anderson P, Neumann T, Nair M, Akins R, Quick D. Radio-Immunotherapy (RIT): Long-term Follow-up Results with I-131 Labeled Antibody in 52 Patients with Non-Hodgkin's Lymphoma (NHL) Refractory to Chemotherapy and Rituxan. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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110
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Mark R, Anderson P, Neumann T, Nair M, Akins R, Gurley S, White D. Interstitial High Dose Rate (HDR) Brachytherapy as Monotherapy for Early Stage Prostate Cancer: A Report of 254 Cases. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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111
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White D, Mark R, Anderson P, Neumann T, Nair M, Akins R. Interstitial High Dose Rate (HDR) Brachytherapy under Local Anesthesia for Early Stage Prostate Cancer: A Report of 420 Cases. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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112
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Gurley S, Mark R, Anderson P, Neumann T, Nair M, Akins R, White D. Linac-stereotactic Radiosurgery (LSRS) in the Management of Trigeminal Neuralgia: An Update of 51 Cases. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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113
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Singh A, Kesavadas C, Radhakrishnan M, Santhosh K, Nair M, Menon G, Radhakrishnan VV. Primary diffuse leptomeningeal gliomatosis. J Neuroradiol 2008; 36:52-6. [PMID: 18707759 DOI: 10.1016/j.neurad.2008.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 20-year-old woman with a history of seizures presented symptoms of walking difficulties for the past six months. Clinical examination was suggestive of a craniovertebral junction anomaly. A cerebrospinal fluid study showed mild protein elevation with no evidence of an infective pathology. Craniospinal MRI revealed diffuse nodular leptomeningeal enhancement of the brain and spinal cord. Histopathological examination was suggestive of a low-grade glioma, and the patient was diagnosed with primary diffuse leptomeningeal gliomatosis. So far, the patient has survived for more than 110 months without aggressive therapy.
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Joseph T, Shaiju P, Laluraj CM, Balachandran KK, Nair M, George R, Nair KKC, Sahayak S, Prabhakaran MP. Nutrient environment of red tide- infested waters off south-west coast of India. ENVIRONMENTAL MONITORING AND ASSESSMENT 2008; 143:355-61. [PMID: 17879133 DOI: 10.1007/s10661-007-9938-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Accepted: 08/28/2007] [Indexed: 05/17/2023]
Abstract
The bloom-infested waters along the southwest coast of India were assessed to bring about the probable cause related to the excessive algal production. Low nitrate and silicate concentrations were concomitant with slightly higher levels of phosphate. The silicate depletion in the bloom area is possibly an indication of community succession (diatom to dinoflagellate), since it was completely utilized by the preceding diatom blooms. The dinoflagellates in this region could have been advected from the northern regions where it was noticed during the previous months.
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115
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Nair M, Colenda J, Anderson P, Mark R, Neumann T, Gurley S. SU-GG-T-46: Dose Volume Analysis of HDR Breast Brachytherapy Plan. Med Phys 2008. [DOI: 10.1118/1.2961796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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116
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Nair M. SU-GG-T-457: Gamma Knife Quality Assurance Technique for Treatment of Functional Disorders. Med Phys 2008. [DOI: 10.1118/1.2962205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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117
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Nair M, Mark R, Smith H, Neumann T, Anderson P. SU-GG-T-437: Localization and Treatment of Essential Tremors Using Gamma Knife Radiosurgery. Med Phys 2008. [DOI: 10.1118/1.2962185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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118
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Mark R, Akins R, Anderson P, Neumann T, Nair M, White D, Gurley S. Interstitial High Dose Rate (HDR) Brachtherapy as Monotherapy for Early Stage Prostate Cancer: A Report of 206 Cases. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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119
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White D, Mark R, Anderson P, Neumann T, Nair M, Gurley S, Akins R. Interstitial High Dose Rate (HDR) Brachytherapy + IMRT vs. HDR Monotherapy for Early Stage Prostate Cancer: A Report of 315 Cases. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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120
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Gurley S, Mark R, Anderson P, Neumann T, Nair M, Akins R, White D. Linac-Stereotactic Radiosurgery (LSRS) in the Management of Trigeminal Neuralgia: A Report of 51 Cases. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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121
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Laluraj CM, Kesavadas V, Balachandran KK, Gerson VJ, Martin GD, Shaiju P, Revichandran C, Joseph T, Nair M. Recovery of an estuary in the southwest coast of India from tsunami impacts. ENVIRONMENTAL MONITORING AND ASSESSMENT 2007; 125:41-5. [PMID: 16897513 DOI: 10.1007/s10661-006-9237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2005] [Accepted: 03/01/2006] [Indexed: 05/11/2023]
Abstract
Water quality in the Cochin Estuary, southwest coast of India during the tsunami attack was assessed and compared with the pre and post tsunami characteristics. From the results obtained, it is evident that a drastic change in hydrography has been inflicted by the energy transferred through the tsunami, which disturbed the entire estuarine embayment. However, the post tsunami water quality showed normal levels indicating that the region has recovered from the tsunami impacts.
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Nair M, Alabi C, Hirsch PI. Toxic shock syndrome: a silent killer. J OBSTET GYNAECOL 2006; 26:825. [PMID: 17130053 DOI: 10.1080/01443610600994734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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123
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Biggs S, Anderson PJ, Mark R, Neumann T, Nair M. Interstitial high dose rate (HDR) brachytherapy for early stage breast cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10551 Background: External Beam Radiation Therapy (EBRT) has been the standard of care for breast conservation radiation therapy. Recent data indicates that Interstitial Implant and High Dose Rate (HDR) radiation afterloading compares favorably to EBRT in selected patients. Methods: Patients with Tis, T1, and T2 tumors measuring ≤ 3 cm, negative surgical margins, and negative axillary lymph nodes were judged to be candidates for Interstitial Implant. Results: Between 2000 and 2006, 112 patients underwent Interstitial HDR Implant under Stereotactic Mammographic guidance with conscious sedation and local anesthesia. Conscious sedation consisted of Morphine and Versed. Local anesthesia was given with a mixture of 1% Lidocaine, 0.25% Marcaine, 1:100,000 Epinephrine, and 4% Sodium Bicarbonate neutralizing solution. The implants were placed using a Template with from 3 to 6 planes, and 8 to 43 needles. Catheters were subsequently threaded thru the needles, and the needles removed. Catheter spacing was 1.0 to 1.5 cm. Radiation Treatment planning was performed using CT Scanning. Treatment volumes ranged from 25 cm3 to 359 cm3. The breast implant volume received 3400 cGy in 10 fractions via HDR prescribed to the Planning Target Volume, given BID over 5 days. The procedure was well tolerated. No patient required hospital admission. With a median follow-up 36 months (range 6–60 months), local recurrence occurred in 2.7% (3/112). Cosmetic results were good to excellent in 85.7% (96/112) of the patients. Wound healing complications developed in 7.1% (8/112). Three of these patients had received anthracycline based Chemotherapy. The other five had large (> 200 cm3) implant volumes and catheter spacing of 1.5 cm. Two patients healed after 6 months of conservative treatment. Surgery was required in six patients who developed fat necrosis. Conclusions: With median 36 month follow-up, Breast Conservation radiation therapy utilizing Interstitial HDR Implant has yielded local recurrence rates and cosmetic results which compare favorably to EBRT in selected patients. Treatment with anthracycline based Chemotherapy and large (> 200 cm3) implant volumes appear to be relative contraindications to Interstitial HDR Implant. Finally, catheter spacing of 1 cm yielded optimal dosimetry and minimized complications. No significant financial relationships to disclose.
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Mark RJ, Anderson PJ, Neumann T, Nair M. Interstitial high dose rate (HDR) brachytherapy alone for early stage prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14633 Background: Transrectal Ultrasound (TRUS) guided interstitial implant for prostate cancer using Low Dose Rate (LDR) and High Dose Rate (HDR) technique has been reported with results comparing favorably to surgery and External Beam Radiation Therapy (EBRT). Often, HDR and LDR interstitial implant is combined with EBRT. There is little published data on HDR alone. We report our results with HDR alone. Methods: Between 1997 and 2006, 167 patients with T1 and T2 localized prostate underwent TRUS guided interstitial implant. There were no Gleason Score or PSA exclusions. No patient received EBRT or Hormonal Blockade. Median Gleason Score was 7 (range: 4 to 10). Median PSA was 9.3 (2.7 to 39.8). Treatment volumes ranged from 42 cm3 to 196 cm3. Treatment volume included the prostate and seminal vesicles in all cases. Our protocol for HDR alone, has called for two HDR Implants. The treatment volume received 2,250 cGy in 3 fractions prescribed to the 100% Isodose line, given over 24 hours. A 2nd implant was performed 4 weeks later, delivering a further 2,250 cGy in 3 fractions, bringing the final dose to the prostate to 4,500 cGy in 6 fractions. Urethral dose points (12–16) were followed, and limited to ≤ 105% of the prescription dose. Results: With a median follow-up of 64 months (range: 6 months to 112 months), PSA disease free survival was 89.8% (150/167). Urethral stricture requiring dilatation has developed in 4.2% (7/167) of patients. Urinary stress incontinence has occurred in 3.6% (6/167). RTOG late bladder toxicities were: 0% Grade 4, 0% Grade 3, and 3.6% (6/167) Grade 2. RTOG late rectal toxicities were: 0.6% (1/167) Grade 4, 0% Grade 3, 1.8% (3/167) Grade 2, and 2.4% (4/167) Grade 1. There have been no cases of rectal incontinence to date. Conclusions: Five year results with HDR implant alone compare favorably to EBRT, LDR ± EBRT, and HDR + EBRT, both with regard to PSA disease free survival, and complications. HDR offers other advantages over LDR, such as no radiation exposure to hospital personnel, no seed migration, greater dose flexibility and precision of radiation dose delivery. Larger volumes can be treated with HDR. By omitting EBRT, bladder and rectal complications appear to be significantly reduced. No significant financial relationships to disclose.
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Gurley S, Mark R, Anderson PJ, Neumann T, Nair M. Linac-stereotactic radiosurgery (LSRS) in the management of trigeminal neuralgia. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18603 Background: Stereotactic Radiosurgery (SRS) with the Gamma Knife (GK) has been used successfully in the treatment of Trigeminal Neuralgia (TN). Results have been comparable to open surgery. There have been few reports with the use of LSRS in the management of TN. We report our updated results with LSRS in the treatment of TN. Methods: Between 2000 and 2006, 37 patients with medically refractory TN were treated with LSRS. Prior neurosurgical intervention had been performed in 28 patients. Ten patients had one procedure, 10 patients two, and 3 patients three interventions. All patients had typical TN. LSRS was given to the cranial nerve V entry root zone into the brainstem. Targeting was defined by CT and MRI Scans, and CT Cisternogram, utilizing axial, coronal, and sagittal images. Treatment planning was accomplished thru the Radionics Treatment Planning System. The dose was 87 Gy to Dm, in one fraction using the 5 mm collimator and 6 arcs with the 20% Isodose line just touching the brainstem. This dosimetry is similar to Gamma Knife. The dose rate was 400 MU/min. Average Arc length was 130 degrees. Response to treatment was defined as excellent (no pain, off analgesics), good (no pain, with analgesics), and poor (continued pain despite analgesics). Results: With a median follow-up of 40 months (range 6–72 months), 73% (27/37) of patients have reported an excellent or good result after LSRS. One patient has sustained permanent ipsilateral facial numbness. Conclusions: LSRS offers comparable results to Gamma Knife SRS, with respect to both pain relief and complications, in the management of TN. No significant financial relationships to disclose.
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