The efficacy of gamma knife radiosurgery in patients with trigeminal neuralgia: The initial experience of the Bezmialem Vakif University.

BACKGROUND: Gamma knife stereotactic radiosurgery is, compared with surgical treatment, a less invasive treatment option for patients with trigeminal neuralgia (TN). AIM: In this report, we analyzed the effect and safety of gamma knife radiosurgery performed in patients with TN. MATERIALS AND METHODS: We retrospectively reviewed patients who underwent gamma knife radiosurgery for TN between June 2014 and January 2017. All patients were treated with Leksell Gamma Knife Model C (Elekta, Stockholm, Sweden) with a prescription dose of 40 Gy with a 50% isodose line. The follow-up of the patients was performed 1 week after the procedure and after every 3 months. The pain score of the patients was recorded using the visual analog scale (VAS). Complications were also reviewed. STATISTICAL ANALYSIS: Statistical analysis was performed using the Statistical Package for the Social Sciences software for Windows, version 23.0. RESULTS: Twenty-four patients (10 males, 14 females) were included in the study. The median age of the patients was 62.5 years (range, 34-91 years). The pre-gamma knife median VAS was 10 (range, 5-10), and the median VAS was 1 (range, 0-10) during the last follow-up. The pain decreased in 16 (76%) patients. Two patients (9%) had treatment-related complications. One patient developed hypoesthesia along the dermatome of the maxillary branch of the fifth cranial nerve and another patient developed facial paresis, which recovered after the usage of steroids for 3 months. CONCLUSION: Gamma knife radiosurgery is an effective and safe treatment for patients with TN with an acceptable pain control rate.

The correlation between phosphorylated Histone H3 (PHH3) and p-STAT3 in Meningiomas.

OBJECTIVE: To assess the correlation between PHH-3 and STAT-3 in grade I and grade II meningiomas. PATIENTS AND METHODS: Medical records were retrospectively reviewed for all cranial cases which diagnosed and underwent surgery at Bezmialem Vakif University Hospital between 2012 and 2017. All cranial grade I and grade II meningioma patients constituted the core sample for this study. RESULTS: This series included 104 (69 female, 35 male) patients, with a median age of 57.3 years. The mean preoperative course was 23.0 ± 40.5 months. The most common symptom was headache (76%) and followed by seizure (24%), weakness (18%) and visual disturbances (14%). Seventy one (68.2%) patients were diagnosed as WHO grade I meningioma and 33 (31.8%) were WHO grade II, grade III meningiomas were excluded from study due to small number of patients. Subtypes of meningioma includes 5 angiomatous (4,8%), 6 fibroblastic (5.7%), 1 meningothelial (0,9%), 11 psammomatous (10,5%), 3 secretory (2,8%), 43 transitional (41,3%) and 33 atypical (31,7%) meningiomas. There is a strong correlation with PHH-3 and Ki-67 (p:0,001>) and mitosis index (p:0,001 > ) although there is no correlation with STAT-3 (p:0,260). There is a strong correlation with STAT-3 and Ki-67 (p:0,013), although there is no correlation with mitosis index (p:0,085) and PHH-3 (p:0,260). CONCLUSIONS: In our study we also obtain same results with Ki-67 and mitotic index, although correlation with PHH-3 and STAT-3 is firstly determined and there was no statistically significant relation were observed. Depends on the STAT-3 cell proliferation feature, inactivation of these pathways may predict new chemotherapies for grade II meningiomas.