I personally would never have gamma. the new statistics coming out are not as positive as they once thought. I have also had 3 neurosurgeons tell me they no longer recommend gamma because they have found it causes destruction that can be impossible to fix.It can make a MVd less likely to be successful. Having said thi, it is just my personal opinion. I know there are many put there that feel gamma was successful for them. another reason I never had gamma was because of my age. I am only 46 and gamma is not usually a permanent fix and you need more than one and you can only have so many. there is also a new study out in the medical journals that says that gamma will put you at a much higher risk for tumors down the road and I certainly don't need any other complications.
I know you don't want to travel,but I would highly recumbent Janetta and Sekula in Pittsburgh at alleghany hospital. I think they are the best and deal with the most trigeminal cases and probably some of the hardest. I so wish Ihad made the effort to gotothemthe first time I had an MVD. I would not have the problems I do now if I had. I know it is very hard to think about the cost and time to travel fora surgery,but it is worth getting the best care. you can call and they will review your records and serif you are a candidate for having another MVD. Any follow up care can be done at home with a local neurologist or neurosurgeon. that is what I did and it was the best decision I made. maybe not the easiest, but the best. I choose my first neurosurgeon because of ease and it was a big mistake.
hope this helps.
Easygoing