SUNCT syndrome successfully treated by gamma knife radiosurgery: Case report

Keywords: pain, gamma knife, headache, radiosurgery, cluster headache

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     The SUNCT syndrome (short-unilateral neuralgiform headache with conjunctival injection and tearing) can be very disabling for affected patients and is often refractory to medical management. 
     We report the first case of SUNCT with a successful response to stereotactic radiosurgery without any adverse effect.
     After failing optimal medical treatment, a 82-year old male patient suffering from right-sided SUNCT syndrome was treated with Gamma knife radiosurgery.
      Because of the presence of autonomic symptoms and similarity with cluster headache, both the trigeminal nerve and sphenopalatine ganglion were targeted with a maximum dose of 80 Gy each using a 4-mm and 8-mm collimator, respectively.
     The patient had complete pain cessation 2 weeks after the treatment. He discontinued his medication 28 months after radiosurgery. He remains pain-free with no medication at the latest follow-up, 46 months after radiosurgery. He did not have any sensory side effect from the procedure.
     This was a single case review.
     Gamma knife radiosurgery is an option for medically-refractory SUNCT patients.
     This finding will require further validation in other patients.


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