• Monica C Mureb, Yosef Dastazirgada, Carolina Benjamin, John G Golfinos, and Douglas Kondziolka.
• Department of Neurosurgery, New York University School of Medicine, New York, New York, USA.
• World Neurosurg. 2020 Jul 1; 139: 242-244.

BackgroundSome petroclival meningiomas cause trigeminal nerve compression, leading to disabling trigeminal neuralgia (TN). Tumor resection and nerve decompression can offer pain relief but might not be feasible in all patients. Simultaneous stereotactic radiosurgery (SRS) to the tumor and nerve is another option. SRS is an effective means of treating meningiomas and TN separately, but data on the efficacy and outcomes of their concomitant treatment are limited.Case DescriptionWe report a series of 4 patients who presented with TN secondary to a petroclival mass causing compression of the trigeminal nerve. All patients underwent SRS to both the petroclival mass and trigeminal nerve in a single session. The average margin tumor dose was 12.25 Gy (range, 12-12.5 Gy), and the average maximum trigeminal nerve dose was 80 Gy (range, 75-85 Gy). In all patients, before intervention, the Barrow Neurologic Institute (BNI) pain intensity score was grade IV or V. At last follow-up (average, 29.8 months), all patients were pain-free (BNI I or IIIA). Two patients experienced reduced facial sensation in 1 or all 3 distributions. No brainstem edema was seen.ConclusionsThis series highlights the benefits and safety of simultaneous treatment of petroclival tumors and the trigeminal nerve in a single session for patients affected by tumor-related TN.Copyright © 2020 Elsevier Inc. All rights reserved.

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