Neurosurgery clinics of North America
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Trigeminal neuralgia is characterized by severe, episodic pain in the trigeminal nerve distribution. Medical therapy is the first line treatment. ⋯ We review the literature and suggest that microvascular decompression remains the gold standard operative therapy. For patients with recurrent pain or who are poor operative candidates, percutaneous radiofrequency rhizotomy offers the best pain response rates and has the advantage of being able to selectively target affected trigeminal divisions.
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Detailed brain imaging studies discover gliomas incidentally before clinical symptoms or signs show. These tumors represent an early stage in the natural history of gliomas. ⋯ Because incidental gliomas are typically smaller and less likely to be in eloquent brain locations, there is a strong case for early surgical intervention to maximize resection and improve outcomes. This article discusses developments in the surgical management of low-grade gliomas.