The most common side effect of extremely high point-dose radiosurgery to the trigeminal nerve for trigeminal neuralgia is—you guessed it—facial numbness. This dosimetric analysis attempts to nail down predictors to inform future planning objectives. Of 136 such treatments, 88% produced and pain response and 59 (43%) resulted in numbness, mostly grade 2 (n=52). While there was no clear dose response at brainstem or Meckel’s cave to incite numbness, there were indications that higher prescription dose, trigeminal nerve maximum dose of 85 Gy, and the volume of trigeminal nerve receiving ≥40 Gy correlated with subsequent facial numbness. | Monroe, Pract Radiat Oncol 2024
