184 Cranial Nerve Function Before and After Stereotactic Radiosurgery for Cavernous Sinus Meningiomas

Neurosurgery ◽  
2012 ◽  
Vol 71 (2) ◽  
pp. E571-E572 ◽  
Author(s):  
Hideyuki Kano ◽  
Kyung-Jae Park ◽  
Aditya K. Iyer ◽  
Ajay Niranjan ◽  
John Flickinger ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Nerve Function ◽  
Cranial Nerve Function ◽  
Before And After

Does Prior Microsurgery Improve or Worsen the Outcomes of Stereotactic Radiosurgery for Cavernous Sinus Meningiomas?

Neurosurgery ◽  
2013 ◽  
Vol 73 (3) ◽  
pp. 401-410 ◽  
Author(s):  
Hideyuki Kano ◽  
Kyun-Jae Park ◽  
Douglas Kondziolka ◽  
Aditya Iyer ◽  
Xiaomin Liu ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Progression Free Survival ◽  
Tumor Control ◽  
Improvement Rate ◽  
Cranial Nerve Function ◽  
Cranial Neuropathies ◽  
Microsurgical Resection

Abstract BACKGROUND: Stereotactic radiosurgery (SRS) is an important option for patients with cavernous sinus meningiomas. OBJECTIVE: To evaluate cranial nerve outcomes in patients who underwent SRS for cavernous sinus meningiomas with or without prior microsurgery. METHODS: During a 23-year interval, 272 patients underwent Gamma Knife SRS for cavernous sinus meningiomas (70 men, 202 women; median age, 54 years). In this series, 99 patients underwent prior microsurgical resection. The median tumor volume was 7.9 cm3 and median marginal dose was 13 Gy. The median follow-up period was 62 months (range, 6-209 months). RESULTS: The progression-free survival after SRS was 96% at 3 years, 94% at 5 years, and 86% at 10 years. After SRS, 13 of 91 patients (14%) who underwent prior microsurgery had improvement of preexisting cranial nerve symptoms or signs. In comparison, 54 of 145 patients (37%) without prior microsurgery had improvement of preexisting cranial nerve symptoms or signs. The improvement rate of cranial nerve deficits after SRS in patients without prior microsurgery was 20% at 1 year, 34% at 2 years, 36% at 3 years, and 39% at 5 years. Patients who had not undergone prior microsurgery had significantly higher improvement rates of preexisting cranial nerve symptoms and signs (P = .001). After SRS, 29 patients (11%) developed new or worsened cranial nerve function. CONCLUSION: SRS provided long-term effective tumor control and a low risk of new cranial nerve deficits. Improvement in preexisting cranial neuropathies was detected in significantly more patients who had not undergone prior microsurgical procedures.

Stereotactic radiosurgery for acoustic nerve tumors in patients with useful preoperative hearing: results at 2-year follow-up examination

1994 ◽  
Vol 80 (6) ◽  
pp. 1011-1017 ◽  
Author(s):  
Olusola K. Ogunrinde ◽  
L. Dade Lunsford ◽  
John C. Flickinger ◽  
Douglas Kondziolka
Keyword(s):  
Stereotactic Radiosurgery ◽  
Trigeminal Nerve ◽  
Cranial Nerve ◽  
Nerve Function ◽  
Content Type ◽  
Acoustic Neuromas ◽  
Cranial Nerve Function ◽  
Acoustic Nerve ◽  
Radiation Beams ◽  
Fine Print

✓ Twenty patients with acoustic nerve tumors (mean diameter ≤ 30 mm) and useful preoperative hearing were examined 2 years after stereotactic radiosurgery to determine the effectiveness of the surgery in the control of tumor growth and the preservation of cranial nerve function. Results showed tumor volume stabilization (12 cases) or reduction (seven cases) was achieved in a total of 19 patients (95%). Useful hearing (defined as Gardner and Robertson Class I or II) preservation was obtained in 100% of cases immediately postoperatively, 50% at 6 months, and 45% at both 1 and 2 years. Two years after stereotactic radiosurgery, facial nerve function was preserved in 90% of patients and 75% continued to have normal trigeminal nerve function. All patients returned to and maintained their preoperative functional status within 3 to 5 days after radiosurgery. These findings indicate that stereotactic radiosurgery with multiple isocenters and narrow radiation beams is a safe and effective management strategy for progressive acoustic nerve tumors. Auditory, facial, and trigeminal nerve function can be preserved in most patients. Prevention of further growth and preservation of cranial nerve function appear to be satisfactory goals in the current management of patients with acoustic neuromas.

Decompression of cavernous sinus meningioma for preservation and improvement of cranial nerve function

2006 ◽  
Vol 105 (1) ◽  
pp. 148-152 ◽  
Author(s):  
William T. Couldwell ◽  
Peter Kan ◽  
James K. Liu ◽  
Ronald I. Apfelbaum
Keyword(s):  
Optic Nerve ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Combined Therapy ◽  
Growth Control ◽  
Good Control ◽  
Neural Function ◽  
Nerve Function ◽  
Cavernous Sinus Meningioma ◽  
Cranial Nerve Function

✓ Meningiomas are the most common tumors affecting the cavernous sinus (CS). Despite advances in microsurgery and radiosurgery, treatment of CS meningiomas remains difficult and controversial. As in cases of other meningiomas, the goal of treatment for CS meningioma is long-term growth control and preservation of neural function. Gross-total resection, the ideal treatment for meningioma, is not always possible to obtain in patients with CS meningiomas with an acceptable level of morbidity. Therefore, microsurgery and radiosurgery have recently been advocated as a combined therapy to achieve good control of tumor growth and favorable functional outcome. The authors describe a technique in which tumor volume can be reduced to a minimal residual amount, while preserving cranial nerve function. This enables the smallest field to be treated radiosurgically. The optic nerve is decompressed, and the tumor mass is reduced to provide at least a 5-mm interpositional distance between the optic nerve and the residual lesion. Direct decompression of the CS, with opening of the lateral and superior sinus walls, and piecemeal removal of the tumor in “safe” locations are performed to facilitate an improvement in cranial nerve function. The authors describe the use of this technique in a series of patients and demonstrate improvement of cranial nerve function in a subset of these patients.

Decompression of Cavernous Sinus Meningioma for Preservation and Improvement of Cranial Nerve Function

Skull Base ◽  
2007 ◽  
Vol 16 (S 1) ◽  
Author(s):  
William Couldwell ◽  
Peter Kan ◽  
James Liu ◽  
Ronald Apfelbaum
Keyword(s):  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Nerve Function ◽  
Cavernous Sinus Meningioma ◽  
Cranial Nerve Function

scholarly journals Effectiveness and Toxicity of Fractionated Proton Beam Radiotherapy for Cranial Nerve Schwannoma Unsuitable for Stereotactic Radiosurgery

2021 ◽  
Vol 11 ◽  
Author(s):  
Tanja Eichkorn ◽  
Sebastian Regnery ◽  
Thomas Held ◽  
Dorothea Kronsteiner ◽  
Juliane Hörner-Rieber ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Proton Beam ◽  
Cranial Nerve ◽  
Tumor Control ◽  
Special Importance ◽  
Nerve Function ◽  
Proton Beam Radiotherapy ◽  
Cranial Nerve Dysfunction ◽  
Cranial Nerve Function

PurposeIn this benign tumor entity, preservation of cranial nerve function is of special importance. Due to its advantageous physical properties, proton beam radiotherapy (PRT) is a promising approach that spares healthy tissue. Could PRT go along with satisfactory preservation rates for cranial nerve function without compromising tumor control in patients with cranial nerve schwannoma unsuitable for stereotactic radiosurgery?MethodsWe analyzed 45 patients with cranial nerve schwannomas who underwent PRT between 2012 and 2020 at our institution. Response assessment was performed by MRI according to RECIST 1.1, and toxicity was graded following CTCAE 5.0.ResultsThe most common schwannoma origin was the vestibulocochlear nerve with 82.2%, followed by the trigeminal nerve with 8.9% and the glossopharyngeal nerve as well as the vagal nerve, both with each 4.4%. At radiotherapy start, 58% of cranial nerve schwannomas were progressive and 95.6% were symptomatic. Patients were treated with a median total dose of 54 Gy RBE in 1.8 Gy RBE per fraction. MRI during the median follow-up period of 42 months (IQR 26–61) revealed stable disease in 93.3% of the patients and partial regression in 6.7%. There was no case of progressive disease. New or worsening cranial nerve dysfunction was found in 20.0% of all patients, but always graded as CTCAE °I-II. In seven cases (16%), radiation-induced contrast enhancements (RICE) were detected after a median time of 14 months (range 2–26 months). RICE were asymptomatic (71%) or transient symptomatic (CTCAE °II; 29%). No CTCAE °III/IV toxicities were observed. Lesions regressed during the follow-up period in three of the seven cases, and no lesion progressed during the follow-up period.ConclusionThese data demonstrate excellent effectiveness with 100% local control in a median follow-up period of 3.6 years with a promising cranial nerve functional protection rate of 80%. RICE occurred in 16% of the patients after PRT and were not or only mildly symptomatic.

Cortical and Subcortical Substrates of Cranial Nerve Function

2015 ◽  
Vol 36 (3) ◽  
pp. 275-290
Author(s):  
Mohit Agarwal ◽  
John L. Ulmer ◽  
Andrew P. Klein ◽  
Leighton P. Mark
Keyword(s):  
Cranial Nerve ◽  
Nerve Function ◽  
Cranial Nerve Function

Cranial nerve function in workers exposed to polychlorinated dioxins and furans

2002 ◽  
Vol 106 (3) ◽  
pp. 155-158 ◽  
Author(s):  
F. Thomke ◽  
D. Jung ◽  
R. Besser ◽  
R. Roder ◽  
J. Konietzko ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Nerve Function ◽  
Dioxins And Furans ◽  
Cranial Nerve Function

Preservation of Cranial Nerve Function after Treatment of Acoustic Neurinomas with Fractionated Stereotactic Radiotherapy

1995 ◽  
Vol 64 (4) ◽  
pp. 165-182 ◽  
Author(s):  
David W. Andrews ◽  
Craig L. Silverman ◽  
Jon Glass ◽  
Beverly Downes ◽  
Richard J. Riley ◽  
...  
Keyword(s):  
Stereotactic Radiotherapy ◽  
Cranial Nerve ◽  
Fractionated Stereotactic Radiotherapy ◽  
Nerve Function ◽  
Cranial Nerve Function ◽  
Acoustic Neurinomas

Richard Lower (1631–1691): acknowledging his notable contributions to the exploration of the nervous system

2009 ◽  
Vol 111 (5) ◽  
pp. 1096-1101 ◽  
Author(s):  
R. Shane Tubbs ◽  
Marios Loukas ◽  
Michael Hill ◽  
Mohammadali M. Shoja ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Nervous System ◽  
Cranial Nerve ◽  
17Th Century ◽  
Nerve Function ◽  
Cranial Nerve Function ◽  
Highly Skilled ◽  
Medical Career ◽  
Physiological Studies ◽  
The Impact

Richard Lower (1631–1691), an anatomist and physician, was born in St. Tudy, Cornwall, England, and became an avid follower of William Harvey and a pupil to Sir Thomas Willis. Unfortunately, little is written of his contributions to the study of the nervous system despite his successful medical career and his regard as one of the most significant English physiologists of the 17th century. Lower was best known for his remarkable studies within the cardiovascular and respiratory disciplines. However, although not as well documented and thus often overlooked, Lower produced noteworthy advancements within the field of neuroscience such as studying the hindbrain innervation of the heart, CSF formation and circulation, cranial nerve function, and the structural sources of seizures. Some have even attributed the results of Willis' anatomical and physiological studies to Lower rather than to Willis himself. Lower has not received the recognition he is owed as a highly skilled and trained anatomist and physician. In this paper, the neurological contributions, with a brief mention of challenges, delivered during the 17th century by this influential historical physician will be highlighted with an emphasis on the impact each contribution made.

Sign in / Sign up

Export Citation Format

Share Document