Gamma Knife Radiosurgery of Distal Aneurysm: A Case Series

2021 ◽  
pp. 1-6
Author(s):  
Roman Liscak ◽  
Josef Vymazal ◽  
Tomas Chytka
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Case Series ◽  
Gamma Knife Surgery ◽  
Neurological Symptoms ◽  
Invasive Technique ◽  
Feeding Artery ◽  
Peripheral Dose ◽  
Control Angiography

A series of 3 patients (35–60 years old) with bleeding distal aneurysm not associated with AVM who underwent radiosurgery by gamma knife are reported. One isocentre centralized over the aneurysm was used; peripheral dose 24–28.8 Gy was applied. Control angiography 20–36 months after gamma knife surgery (GKS) demonstrated obliteration of both the aneurysm and the feeding artery, without deterioration of the neurological symptoms. Our case series implies that GKS might serve as a safe mini-invasive technique in the treatment of selected distal aneurysms.

scholarly journals MLTI-15. A CASE SERIES OF PRE-OPERATIVE GAMMA-KNIFE RADIOSURGERY FOR RESECTABLE BRAIN METASTASES

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i17-i17
Author(s):  
Tatsuya Takezaki ◽  
Haruaki Yamamoto ◽  
Naoki Shinojima ◽  
Jun-ichiro Kuroda ◽  
Shigeo Yamashiro ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Systemic Treatment ◽  
Radiation Necrosis ◽  
Gamma Knife Radiosurgery ◽  
Case Series ◽  
Phase 3 ◽  
Optimal Sequence ◽  
Median Margin

Abstract Recent advances in the systemic treatment of various cancers have resulted in longer survival and higher incidence of brain metastases. Phase 3 trials in north America and in Japan have demonstrated that stereotactic radiosurgery will be a standard adjuvant modality following surgery for resectable brain metastases. However, we don’t know the optimal sequence of this combination therapy. We hypothesized that pre-operative stereotactic radiosurgery for resectable brain metastases provides favorable rates of local control, overall survival, leptomeningeal dissemination and symptomatic radiation necrosis. We have experienced 4 cases of resected brain metastases within 1–7 days after Gamma-knife surgery (median margin dose:22Gy) and have been following their clinical course. We will show the repressive cases.

scholarly journals Clinical results of Gamma Knife surgery for cavernous sinus hemangiomas

2012 ◽  
Vol 117 (Special_Suppl) ◽  
pp. 89-95 ◽  
Author(s):  
Peng Li ◽  
Haibo Ren ◽  
Shizhen Zhang ◽  
Wei Wang
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Adjuvant Treatment ◽  
Clinical Results ◽  
Gamma Knife Surgery ◽  
Mr Images ◽  
Peripheral Dose ◽  
Long Term Follow Up ◽  
Model C

Object The purpose of this study was to gain an understanding of the efficacy and safety of Gamma Knife surgery (GKS) for the treatment of cavernous sinus hemangiomas (CSHs). The authors report on 16 patients who underwent GKS as a primary or adjuvant treatment for CSH. Methods Sixteen patients harboring CSHs (14 women and 2 men ranging in age from 21 to 65 years [mean 41.3 years]) underwent GKS at West China Hospital. In 4 patients the diagnosis was based on histological findings; in the other 12 patients it was based on findings on MR images. After patients were given a local anesthetic agent, the treatments were performed using a Leksell Gamma Knife model C. Gadolinium-enhanced MR images of T1-weighted, T2-weighted, and FLAIR sequences were obtained to determine the pretreatment location of the lesion. A mean peripheral dose of 13.3 Gy (range 11–14 Gy) was directed to the 40%–50% isodose line. Results The mean follow-up time in this study was 21.5 months (range 12–36 months). In 11 of 12 patients with symptoms, clinical improvement was reported at an average of 3.3 months (range 1–8 months) after GKS. Significant or partial tumor shrinkage was observed in 14 patients (87.5%) at the last follow-up. No new neurological impairments were reported after GKS. Conclusions Magnetic resonance imaging may play an important role in the preoperative diagnosis of CSHs. Gamma Knife surgery may be a safe and effective primary or adjuvant treatment option for CSHs; however, long-term follow-up with more cases is needed to verify the benefits of this treatment.

Gamma Knife Surgery for Recurrent Solitary Metastasis of a Cerebral Hypernephroma: Case Report

Neurosurgery ◽  
1989 ◽  
Vol 25 (5) ◽  
pp. 802-804 ◽  
Author(s):  
Christer Lindquist
Keyword(s):  
Case Report ◽  
Gamma Knife ◽  
Palliative Treatment ◽  
Gamma Knife Surgery ◽  
Cerebral Metastasis ◽  
Peripheral Dose ◽  
Solitary Metastasis ◽  
Computed Tomographic ◽  
Computed Tomographic Scan ◽  
Progressive Necrosis

Abstract Gamma knife surgery employing a central dose of 70 Gy and a peripheral dose of 25 Gy caused progressive necrosis and shrinkage of a recurrent solitary metastasis of a cerebral hypernephroma, as verified by computed tomographic scan 2 and 4 months after treatment. Gamma knife surgery was an effective palliative treatment for this cerebral metastasis and was an alternative to craniotomy with microsurgical removal.

A practical grading scale for predicting outcome after radiosurgery for arteriovenous malformations: analysis of 1012 treated patients

2013 ◽  
Vol 119 (4) ◽  
pp. 981-987 ◽  
Author(s):  
Robert M. Starke ◽  
Chun-Po Yen ◽  
Dale Ding ◽  
Jason P. Sheehan
Keyword(s):  
Multivariate Analysis ◽  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Favorable Outcome ◽  
Peripheral Dose ◽  
Long Term Outcome ◽  
Radiation Induced ◽  
Grading Scale

Object The authors performed a study to review outcomes following Gamma Knife radiosurgery for cerebral arteriovenous malformations (AVMs) and to create a practical scale to predict long-term outcome. Methods Outcomes were reviewed in 1012 patients who were followed up for more than 2 years. Favorable outcome was defined as AVM obliteration and no posttreatment hemorrhage or permanent, symptomatic, radiation-induced complication. Preradiosurgery patient and AVM characteristics predictive of outcome in multivariate analysis were weighted according to their odds ratios to create the Virginia Radiosurgery AVM Scale. Results The mean follow-up time was 8 years (range 2–20 years). Arteriovenous malformation obliteration occurred in 69% of patients. Postradiosurgery hemorrhage occurred in 88 patients, for a yearly incidence of 1.14%. Radiation-induced changes occurred in 387 patients (38.2%), symptoms in 100 (9.9%), and permanent deficits in 21 (2.1%). Favorable outcome was achieved in 649 patients (64.1%). The Virginia Radiosurgery AVM Scale was created such that patients were assigned 1 point each for having an AVM volume of 2–4 cm3, eloquent AVM location, or a history of hemorrhage, and 2 points for having an AVM volume greater than 4 cm3. Eighty percent of patients who had a score of 0–1 points had a favorable outcome, as did 70% who had a score of 2 points and 45% who had a score of 3–4 points. The Virginia Radiosurgery AVM Scale was still predictive of outcome after controlling for predictive Gamma Knife radiosurgery treatment parameters, including peripheral dose and number of isocenters, in a multivariate analysis. The Spetzler-Martin grading scale and the Radiosurgery-Based Grading Scale predicted favorable outcome, but the Virginia Radiosurgery AVM Scale provided the best assessment. Conclusions Gamma Knife radiosurgery can be used to achieve long-term AVM obliteration and neurological preservation in a predictable fashion based on patient and AVM characteristics.

Peripheral dose in ocular treatments with CyberKnife and Gamma Knife radiosurgery compared to proton radiotherapy

2007 ◽  
Vol 52 (19) ◽  
pp. 5957-5971 ◽  
Author(s):  
A Zytkovicz ◽  
I Daftari ◽  
T L Phillips ◽  
C F Chuang ◽  
L Verhey ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Proton Radiotherapy ◽  
Peripheral Dose

PITUITARY ADENOMAS TREATED WITH GAMMA KNIFE RADIOSURGERY

Neurosurgery ◽  
2007 ◽  
Vol 61 (2) ◽  
pp. 270-280 ◽  
Author(s):  
M. Necmettin Pamir ◽  
Türker Kiliç ◽  
Muhittin Belirgen ◽  
Ufuk Abacioğlu ◽  
Nural Karabekiroğlu
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Pituitary Adenomas ◽  
Gamma Knife Radiosurgery ◽  
Volumetric Analysis ◽  
First Year ◽  
Volume Changes ◽  
Peripheral Dose ◽  
Initial Volume

Abstract OBJECTIVE To analyze pituitary adenoma volume changes after gamma knife radiosurgery (GKRS) in patients with 3 years of follow-up and to investigate factors that might affect these changes. METHODS Between January 1997 and March 2004, a total of 1930 patients were treated in the Gamma Knife Unit of the Marmara University Department of Neurosurgery in Istanbul, Turkey. Three hundred sixty of these patients had pituitary adenomas (PAs). This prospectively designed clinical study documents the radiological-volumetric analysis for the first 100 of these patients with PAs who had a minimum of 3 years of follow-up and met the study requirements. Each tumor was assessed with serial magnetic resonance imaging scans after radiosurgery; at each time point, adenoma volume was expressed as a percentage of the tumor's initial volume. Volume changes were investigated relative to margin dose, the cavernous sinus infiltration, and endocrinological type of adenoma. RESULTS At the end of the first year after GKRS, the PA volumes had decreased to approximately 90% of the initial volume on average. The corresponding approximate averages for the ends of Years 2 and 3 were 80 and 70% of the initial volume, respectively. At 3 years after GKRS, the PAs in the group with a peripheral dose of less than 17 Gy were reduced to approximately 80% of the initial volume on average. In contrast, the tumors in the patients with marginal doses of 21 to 23 Gy were reduced to approximately 60% of the initial volume at this stage. The adenomas treated with the highest marginal doses (>27 Gy) showed the earliest volume decreases after GKRS (6–9 mo after the procedure). Cavernous sinus noninfiltrating adenomas showed greater volume decreases after GKRS; on average, these masses were reduced to approximately 50% of their initial volume at 3 years. In contrast, the PAs that had infiltrated the cavernous sinus had only dropped to approximately 80% of their initial volume at this stage. The growth hormone-secreting PAs showed the maximum volume decrease with GKRS. On average, these lesions were approximately 60% of their initial volume at the 3-year stage. The nonfunctioning tumors and the prolactin-secreting adenomas showed similar volume changes over time. On average, these tumors had dropped to approximately 75 and 70% of the initial volume, respectively, by 3 years after GKRS. CONCLUSION Gamma knife radiosurgery halts the growth of pituitary adenomas. Cavernous sinus extension and margin dose are the most important determinants of adenoma volume after this type of therapy.

Long-term outcomes after Gamma Knife surgery for vestibular schwannomas: a 10-year experience

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 149-153 ◽  
Author(s):  
Dong Liu ◽  
Desheng Xu ◽  
Zhiyuan Zhang ◽  
Yipei Zhang ◽  
Ligao Zheng
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Vestibular Schwannomas ◽  
Hearing Improvement ◽  
Long Term Outcomes ◽  
Peripheral Dose ◽  
Function Preservation ◽  
The Mean

ObjectThe authors sought to assess the results of Gamma Knife surgery (GKS) in patients with vestibular schwannomas (VSs).MethodsSeventy-four consecutive patients (33 men and 41 women) were evaluated by means of serial imaging studies, clinical examinations, and questionnaires. Nineteen patients had undergone resection of their VS. Facial nerve function was normal in 63 patients (85.1%) before GKS, and 63.5% of them had useful hearing. The prescription peripheral dose varied between 10 and 14 Gy (mean 12.27 ± 0.96 Gy); the corresponding central dose was 21 to 30 Gy (mean 24.9 ± 2.18 Gy). The mean volume of the tumor at GKS was 10.79 ± 5.52 ml (range 0.11–27.8 ml). A mean of eight isocenters (range 3–17) was used for treating these lesions.At a median follow-up period of 68.3 months (range 30–122 months), tumor shrinkage was observed in 60 patients (81.1%), and the tumor size was stable in 11 (14.8%). Persistent neuroimaging demonstrated evidence of progression in only three patients (4.1%): two underwent repeated GKS after an interval of 18 months and one continues to be observed. Five patients experienced trigeminal dysfunction: in three the dysfunction was transient and in the other two the dysfunction persists. Three patients suffered facial palsy. Useful hearing was preserved in 34 patients. Thirteen patients experienced some degree of hearing improvement. Deterioration of hearing was found in 13 of 62 patients who had Class I or II hearing before treatment.Conclusions Gamma Knife surgery prevents tumor growth; it achieves excellent neurological function preservation and produces few treatment-related complications.

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