OBJECT Gamma Knife radiosurgery (GKRS) is the least invasive treatment option for medically refractory, intractable @entity4254 ( @entity4254 ) and is especially valuable for treating elderly, infirm @entity1 or those on anticoagulation therapy. The authors reviewed @entity158 outcomes and complications in @entity4254 @entity1 who required 3 radiosurgical procedures for recurrent or persistent @entity158 . METHODS A retrospective review of all @entity1 who underwent 3 GKRS procedures for @entity4254 at 4 participating centers of the North American Gamma Knife Consortium from 1995 to 2012 was performed. The Barrow Neurological Institute (BNI) @entity158 score was used to evaluate @entity158 outcomes. RESULTS Seventeen @entity1 were identified; 7 were male and 10 were female. The mean age at the time of last GKRS was 79.6 years (range 51.2-95.6 years). The @entity4254 was Type I in 16 @entity1 and Type II in 1 @entity1 . No @entity1 suffered from @entity15 . Eight @entity1 (47.1%) reported initial @entity158 relief (BNI Score I) following their third GKRS and 8 others (47.1%) experienced at least partial relief (BNI Scores II-IIIb). The average time to initial response was 2.9 months following the third GKRS. Although 3 @entity1 (17.6%) developed new facial @entity409 following primary GKRS and 2 @entity1 (11.8%) experienced new or worsening @entity132 following the second GKRS, no @entity1 sustained additional @entity132 after the third procedure. At a mean follow-up of 22.9 months following the third GKRS, 6 @entity1 (35.3%) reported continued Score I @entity158 relief, while 7 others (41.2%) reported @entity158 improvement (BNI Scores II-IIIb). Four @entity1 (23.5%) suffered recurrent @entity4254 following the third procedure at a mean interval of 19.1 months. CONCLUSIONS A third GKRS resulted in @entity158 reduction with a low risk of additional complications in most @entity1 with medically refractory and recurrent, intractable @entity4254 . In @entity1 unsuitable for other microsurgical or percutaneous strategies, especially those receiving long-term oral anticoagulation or antiplatelet agents, GKRS repeated for a third time was a satisfactory, low risk option.

The results of a third Gamma Knife procedure for recurrent XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity132 :: ('MESH:D010468', 'Disease') :: ['sensory disturbances', 'sensory disturbance'] @entity4254 :: ('MESH:D014277', 'Disease') :: ['TN', 'trigeminal neuralgia'] @entity409 :: ('MESH:D008107', 'Disease') :: ['sensory dysfunction'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'complete pain'] @entity15 :: ('MESH:D009103', 'Disease') :: ['multiple sclerosis']
@entity4254 :: (MESH:D014277,Disease) :: ['trigeminal neuralgia']
