scholarly journals Displacement of Gray Matter and Incidence of Seizures in Patients with Cerebral Cavernous Malformations

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1872
Author(s):  
Chi-Jen Chou ◽  
Cheng-Chia Lee ◽  
Ching-Jen Chen ◽  
Huai-Che Yang ◽  
Syu-Jyun Peng
Keyword(s):  
Image Analysis ◽  
Gamma Knife ◽  
Gray Matter ◽  
Gamma Knife Radiosurgery ◽  
Initial Presentation ◽  
Cerebral Cavernous Malformations ◽  
Strongly Correlated ◽  
Cavernous Malformations ◽  
Common Presentation ◽  
Limbic Lobe

Seizures are the most common presentation in patients with cerebral cavernous malformations (CCMs). Based on the hypothesis that the volume or proportion of gray matter (GM) displaced by CCMs is associated with the risk of seizure, we developed an algorithm by which to quantify the volume and proportion of displaced GM and the risk of seizure. Image analysis was conducted on 111 patients with solitary CCMs (divided into seizure and nonseizure groups) from our gamma knife radiosurgery (GKRS) database from February 2005 and March 2020. The CCM algorithm proved effective in quantifying the GM and CCM using T1WI MRI images. In the seizure group, 11 of the 12 patients exhibited seizures at the initial presentation, and all CCMs in the seizure group were supratentorial. The location of the limbic lobe within the CCM was significantly associated with the risk of seizure (OR = 19.6, p = 0.02). The risk of seizure increased when the proportion of GM displaced by the CCM exceeded 31%. It was also strongly correlated with the volume of displaced GM. The volume and proportion of displaced GM were both positively correlated with the risk of seizure presentation/development and thus could be used to guide seizure prophylaxis in CCM patients.

scholarly journals Delayed Radiation Necrosis With Extensive Brain Edema After Gamma Knife Radiosurgery for Multiple Cerebral Cavernous Malformations-Case Report-

2003 ◽  
Vol 43 (8) ◽  
pp. 391-395 ◽  
Author(s):  
Nobuo TAKENAKA ◽  
Tomoyuki IMANISHI ◽  
Hikaru SASAKI ◽  
Kenji SHIMAZAKI ◽  
Hitoshi SUGIURA ◽  
...  
Keyword(s):  
Case Report ◽  
Brain Edema ◽  
Gamma Knife ◽  
Radiation Necrosis ◽  
Gamma Knife Radiosurgery ◽  
Cerebral Cavernous Malformations ◽  
Cavernous Malformations

Gamma knife radiosurgery for brainstem cavernous malformations: should a patient wait for the rebleed?

2014 ◽  
Vol 156 (10) ◽  
pp. 1937-1946 ◽  
Author(s):  
Sung Ho Lee ◽  
Hyuk Jai Choi ◽  
Hee Sup Shin ◽  
Seok Keun Choi ◽  
In Ho Oh ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Cavernous Malformations

Worldwide variance in the potential utilization of Gamma Knife radiosurgery

2016 ◽  
Vol 125 (Supplement_1) ◽  
pp. 160-165 ◽  
Author(s):  
Travis Hamilton ◽  
L. Dade Lunsford
Keyword(s):  
Gamma Knife ◽  
Malignant Tumors ◽  
Vascular Malformations ◽  
Gamma Knife Radiosurgery ◽  
Pituitary Tumors ◽  
Cavernous Malformations ◽  
Electronic Survey ◽  
Significant Variance ◽  
Health Care Barriers

OBJECTIVEThe role of Gamma Knife radiosurgery (GKRS) has expanded worldwide during the past 3 decades. The authors sought to evaluate whether experienced users vary in their estimate of its potential use.METHODSSixty-six current Gamma Knife users from 24 countries responded to an electronic survey. They estimated the potential role of GKRS for benign and malignant tumors, vascular malformations, and functional disorders. These estimates were compared with published disease epidemiological statistics and the 2014 use reports provided by the Leksell Gamma Knife Society (16,750 cases).RESULTSRespondents reported no significant variation in the estimated use in many conditions for which GKRS is performed: meningiomas, vestibular schwannomas, and arteriovenous malformations. Significant variance in the estimated use of GKRS was noted for pituitary tumors, craniopharyngiomas, and cavernous malformations. For many current indications, the authors found significant variance in GKRS users based in the Americas, Europe, and Asia. Experts estimated that GKRS was used in only 8.5% of the 196,000 eligible cases in 2014.CONCLUSIONSAlthough there was a general worldwide consensus regarding many major indications for GKRS, significant variability was noted for several more controversial roles. This expert opinion survey also suggested that GKRS is significantly underutilized for many current diagnoses, especially in the Americas. Future studies should be conducted to investigate health care barriers to GKRS for many patients.

Gamma knife radiosurgery for brainstem cavernous malformations

2016 ◽  
Vol 151 ◽  
pp. 55-60 ◽  
Author(s):  
Hong Bin Liu ◽  
Yi Wang ◽  
Sen Yang ◽  
Fei Long Gong ◽  
Yang Yang Xu ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Cavernous Malformations

scholarly journals SURG-37. SYSTEMATIC REVIEW OF GAMMA-KNIFE RADIOSURGERY AND MICROSURGICAL RESECTION FOR BRAINSTEM CAVERNOUS MALFORMATIONS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii211-ii211
Author(s):  
Aditya Kondajji ◽  
Thien Nguyen ◽  
John Sheppard ◽  
Daniel Kulinich ◽  
Ansley Unterberger ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Therapeutic Benefit ◽  
Gross Total Resection ◽  
Treatment Modalities ◽  
Bleeding Events ◽  
Total Resection ◽  
Cavernous Malformations ◽  
Microsurgical Resection ◽  
Meta Analyses

Abstract BACKGROUND Although microsurgical resection (MR) remains the gold-standard for the treatment of symptomatic cavernous malformations, some authors have proposed the use of radiosurgical Gamma-Knife Surgery (GKS) for lesions that are deep or eloquent, such as those located in the brainstem. OBJECTIVE Here were analyze the literature regarding patient outcomes following MR or GKS for brain stem cavernous malformations. METHODS This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic literature review. A database search of PubMed, Scopus, Embase, and Web of Science was conducted in September 2019. This review included studies evaluating the outcomes of MR or GKS for cavernous malformations located in the brainstem. RESULTS Gross total resection was achieved in the majority of patients and effectively eliminated the risk of recurrent hemorrhage from the operative lesion in studies following the outcomes of MR. GKS reduces the annual hemorrhage rate for patients, although it does not eliminate the cavernous malformation. Both treatment modalities were effective in reducing prior symptomatology. Unlike resection, GKS only reduces the risk of future hemorrhage and does prevent it. CONCLUSIONS Both MR and GKS can improve or stabilize symptoms in patients. However, the therapeutic benefit of GKS may take months to years to take full-effect, resulting in a potential for subsequent hemorrhagic events. MR remains the best treatment option due to its ability to eliminate future bleeding events entirely and should be performed whenever gross total resection is possible.

scholarly journals Long term results of Gamma Knife radiosurgery for deep-seated cavernous malformations

2021 ◽  
Vol 1 ◽  
pp. 100700
Author(s):  
G. Akyoldas ◽  
M.Y. Samancı ◽  
G.D. Ardor ◽  
S. Peker
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Long Term Results ◽  
Cavernous Malformations

scholarly journals Microsurgery vs. Gamma Knife Radiosurgery for the Treatment of Brainstem Cavernous Malformations: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiangyu Gao ◽  
Kangyi Yue ◽  
Jidong Sun ◽  
Yuan Cao ◽  
Boyan Zhao ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Lower Incidence ◽  
Meta Analysis ◽  
Gamma Knife Radiosurgery ◽  
Incidence Rates ◽  
Cochrane Library ◽  
Focal Neurological Deficit ◽  
Cavernous Malformations ◽  
Symptomatic Intracranial Hemorrhage ◽  
The Cochrane Library

Background: Brainstem cavernous malformations (BSCMs) are a subset of cerebral cavernous malformations with precarious locations and potentially devastating clinical courses. The effects and outcomes of treating BSCMs by microsurgery or gamma knife radiosurgery (GKRS) vary across studies.Methods: We searched the Medline, Web of Science, The Cochrane Library, PubMed, and China Biology Medicine disc databases for original articles published in peer-reviewed journals of cohort studies reporting on 20 or more patients of any age with BSCMs with at least 80% completeness of follow-up.Results: We included 43 cohorts involving 2,492 patients. Both microsurgery (RR = 0.04, 95% CI 0.01–0.16, P < 0.01) and GKRS (RR = 0.11, 95% CI 0.08–0.16, P < 0.01) demonstrated great efficacy in reducing the rehemorrhage rate after treatment for BSCMs. The incidence rates of composite outcomes were 19.8 (95% CI 16.8–22.8) and 15.7 (95% CI 11.7–19.6) after neurosurgery and radiosurgery, respectively. In addition, we found statistically significant differences in the median numbers of patients between neurosurgical and radiosurgical cohorts in terms of symptomatic intracranial hemorrhage (ICH; neurosurgical cohorts: median 0, range 0–33; radiosurgical cohorts: median 4, range 1–14; P < 0.05) and persistent focal neurological deficit (FND; neurosurgical cohorts: median 5, range 0–140; radiosurgical cohorts: median 1, range 0–3; P < 0.05).Conclusions: The reported effects of treating BSCMs by microsurgery or GKRS are favorable for reducing recurrent hemorrhage from BSCMs. Patients in the neurosurgery cohort had a lower incidence of symptomatic ICH, while patients in the radiosurgical cohort had a lower incidence of persistent FND.

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