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Gamma knife surgery of brain cavernous
hemangiomas
Liscak R, Vladyka V, Simonova G, Vymazal J, Novotny J Jr
Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech
Republic. roman.liscak@homolka.cz
Object. The authors conducted a study to record more detailed information
about the natural course and factors predictive of outcome following gamma
knife surgery (GKS) for cavernous hemangiomas.
Methods. One hundred twelve
patients with brain cavernous hemangiomas underwent GKS between 1993 and
2000.
The median prescription dose was 16 Gy.
One hundred seven patients
were followed for a median of 48 months (range 6-114 months).
The rebleeding
rate was 1.6%, which is not significantly different with that prior to
radiosurgery (2%).
An increase in volume was observed in 1.8% of cases and a
decrease in 45%.
Perilesional edema was detected in 27% of patients, which,
together with the rebleeding, caused a transient morbidity rate of 20.5% and
permanent morbidity rate of 4.5%.
Before radiosurgery 39% of patients
suffered from epilepsy and this improved in 45% of them.
Two patients with
brainstem cavernous hemangiomas died due to rebleeding.
Rebleeding was more
frequent in female middle-aged patients with a history of bleeding, a larger
lesion volume, and a prescription dose below 13 Gy.
Edema after GKS occurred
more frequently in patients who had surgery, a larger lesion volume, and in
those in whom the prescription dose was more than 13 Gy.
Conclusions. Gamma
knife surgery of cavernous hemangiomas can produce an acceptable rate of
morbidity, which can be reduced by using a lower margin dose.
Lesion
regression was observed in many patients.
Radiosurgery seems to remain a
suitable treatment modality in carefully selected patients.
PMID: 15662812 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15662812
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