Abstract

BACKGROUND:
Tic douloureux is a debilitating disease presented as a recurrent unilateral short- living, electric, shock -like pain, abrupt in onset and termination, limited to the distribution of one or more division of trigeminal nerve.
OBJECTIVE:  
To evaluate the effectiveness of Gamma Knife® radiosurgery (GKRS) using retrogasserian approach.
PATIENTS AND METHODS:
A follow up review was conducted on twenty patients who were treated with GKRS for refractory TN              at our institution Dr. Saad Al-Witry Neuroscience Hospital in Baghdad, Iraq, between December 2019 and March 2021. T.N pain score was assessed using the Barrow Neurological Institute (BNI) Pain Scale.            An ideal result was counted by post-GKRS BNI score of (I–III), whereas insufficiency outcome was              (IV – V) of same scale.
RESULTS:
From the entire (twenty) GKRS procedures, (85%) of patients had result with remarkable relief in                  their complain (BNI I-III). No noteworthy relation was found between unacceptable outcome and age, sex, side of complain, period of symptoms. Only four cases (20%) developed undesirable outcome                in form of facial numbness.
CONCLUSION:
Considering the satisfactory results in our own experience, GKRS is also offered as a feasible, effective, safe initial and repeat treatment modality targeting patients who were intractable to medical treatment.