Stereotactic Radiosurgery for Cluster Headache: A Single Center Retrospective Study
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Trigeminal autonomic cephalalgias are rare primary headache disorders. Cluster headache (CH) is the most common form. Stereotactic radiosurgery (SRS) is sometimes used in medically refractory cases. This study was designed to evaluate the efficacy of SRS for the management of CH, with specific goals to assess the duration of pain relief, the recurrence rate, and the occurrence of sensory complications. METHODS: A retrospective study of patients who underwent SRS at our institution for CH between 2004 and 2022 was conducted. Baseline demographics, symptoms, and pain characteristics were collected before treatment. Symptoms, pain evolution, and complications were obtained at follow-up. Outcomes were analyzed using the Kaplan-Meier method and descriptive statistics. RESULTS: The cohort included 18 patients. One patient had bilateral pain and was treated sequentially on both sides. Both trigeminal nerve and sphenopalatine ganglion were targeted using a median maximum dose of 80 Gy. SRS yielded adequate pain control (modified Barrow Neurological Institute IIIb or better) in 79% of cases after a median of 4 months. Pain recurred after a median of 27 months in 80% of patients who had initial relief. Repeat SRS for recurrence was effective in 4 of 5 patients. New bothersome facial numbness (Barrow Neurological Institute III or worse) occurred in 16% after primary SRS and 50% after repeat SRS. CONCLUSION: SRS is a reasonable management option for refractory CH. Most patients will see at least transient improvement in pain attacks, but recurrence is common. Rates of bothersome numbness appear lower than previously reported after a single SRS procedure for CH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".