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Gamma knife surgery for intracranial cavernous
hemangioma
Kim MS, Pyo SY, Jeong YG, Lee SI, Jung YT, Sim JH
Department of Neurosurgery, University Busan Paik Hospital, Busan, South
Korea. kinmmo@yahoo.co.kr
Object. The purpose of this study was to assess the benefits of radiosurgery
for cavernous hemangioma.
Methods. Sixty-five cavernous hemangiomas were
treated with gamma knife surgery (GKS) between October 1994 and December
2002.
Forty-two patients attended follow up.
The mean patient age was 37.6
years (range 7-60 years).
The lesions were located in the frontal lobe in 12
cases, deep in the parietal lobe in five, in the basal ganglia in five, in
the temporal in three, in the cerebellum in three, in the pons/midbrain in
six, and in multiple locations in eight cases.
The presenting symptoms were
seizure in 12, hemorrhage in 11, and other in 19.
The maximum dose was 26.78
Gy, and the mean margin dose was 14.55 Gy.
The mean follow-up period after
radiosurgery was 29.6 months (range 5-93 months).
The tumor decreased in
size in 29 cases, was unchanged in 12, and increased in size in one.
In the
seizure group, seizures were controlled without anticonvulsant medication in
nine cases (81.8%) after 31.3 months (range 12-80 months).
After 93 months,
one patient developed a cyst, which was resected.
Rebleeding occurred in one
case (2.3%).
On T2-weighted imaging changes were seen in 11 cases (26.2%),
in three (7.1 %) of which neurological deterioration was correlated with
imaging changes. In other cases these deficits were temporary.
Conclusions.
The authors found that GKS was an effective treatment modality for cavernous
hemangiomas, especially for those located within the brainstem, basal
ganglia, or deep portions of the brain. It can reduce seizure frequency
significantly although this takes time. In the group receiving a marginal
dose below 15 Gy the patients fared better than when the dose exceeded 15
Gy.
PMID: 15662789 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15662789
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