Introduction: Treatment approach for recurrent trigeminal neuralgia (TN) with petro-clival meningioma (PM) is not well understood. In this study, we sought to summaries the treatment approach for recurrent TN with PM.
Methods: We performed a retrospective review of 57 patients with PM. Out of 57, only seven patients presented with trigeminal neuralgia and six patients experienced recurrent TN. The study population was evaluated clinically and radiographically after treatment.
Results: Overall improvement of pain control after different treatment was 83% and tumor control was 100%. The Karnofsky performance scale (KPS) was significantly improved after treatment compared to the pretreated status (78 vs. 88, p=0.044). Results from this study reveals that the patients with recurrent trigeminal pain after initial GKRS should be managed with resection rather using GKRS again because GKRS does not result prolong pain relief. Moreover, patients treated with initial resection, repeated resection or resection with up-front GKRS would be preferable for further intervention since adjunct therapy with GKRS cannot control the pain for a longer period compared to resection.
Conclusions: Microsurgical resection with microvascular decompression is superior to GKRS in achieving and maintaining pain free status in the patients with recurrent trigeminal pain associated with petro-clival meningioma.
Patient Care: The result of this study will reveals the practice pattern of recurrent trigeminal neuralgia with petro-clival meningioma.
Learning Objectives: Management pattern of patients with recurrent trigeminal neuralgia with petro-clival meningioma.