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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Gamma Knife Radiosurgery for SUNCT: A Case Series.

Andrea Franzini1, Davide Milani1, Luca Attuati1

  • 1Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.

Stereotactic and Functional Neurosurgery
|February 2, 2023
PubMed
Summary

Gamma Knife radiosurgery effectively treats chronic SUNCT headaches by reducing pain and autonomic symptoms. While generally safe, some patients may experience mild facial numbness.

Keywords:
Gamma knifeRadiosurgerySUNCTSphenopalatine ganglionTrigeminal autonomic cephalalgiasTrigeminal nerve

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Area of Science:

  • Neurosurgery
  • Neurology
  • Pain Management

Background:

  • Chronic SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) is difficult to treat.
  • Stereotactic radiosurgery targeting the trigeminal nerve and sphenopalatine ganglion (SPG) offers a less-invasive treatment option.

Discussion:

  • Gamma Knife radiosurgery (GKRS) provides a potential therapeutic avenue for medically refractory SUNCT.
  • The study highlights the efficacy of GKRS in alleviating debilitating pain and associated autonomic symptoms.

Key Insights:

  • GKRS targeting both the trigeminal nerve and SPG successfully reduced pain and autonomic symptoms in all 5 SUNCT patients.
  • A significant reduction in pain intensity was observed, with most patients achieving lower Barrow Neurological Institute (BNI) pain scores.
  • Two patients experienced non-bothersome facial numbness, indicating a manageable side effect profile.

Outlook:

  • Further research with larger cohorts is warranted to confirm these findings.
  • GKRS may become a valuable treatment modality for SUNCT patients refractory to conventional therapies.
  • Long-term follow-up studies will be crucial to assess the durability of GKRS effects and potential delayed adverse events.