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Douglas Kondziolka

The authors from Maastricht University in The Netherlands discuss the roles of resection and Gamma Knife surgery (GKS) in the treatment of patients with larger-volume vestibular schwannomas (VSs). In Part I, they discuss the indications for and outcomes in patients who underwent planned subtotal resection followed by GKS. 5 In Part II, they discuss the outcomes in patients who underwent primary GKS alone. 6 The editorial board of the Journal of Neurosurgery had numerous questions for the authors during the review process of these reports, and many

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Editorial

Toward the revaluation of radiosurgery

Douglas Kondziolka

reconsidered. The process was successful, and a recent decision was made to accept the RUC recommendations. It is also interesting to know that the American Board of Neurological Surgery has valued radiosurgery in the training of neurosurgeons for many years. At our own institution, a residency rotation in stereotactic radiosurgery occurred long before a similar experience in our own department of radiation oncology. Although Drs. Adler and Heilbrun 1 call for an increase in funded radiosurgery fellowships, such fellowships already exist. There are a number of

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Current and novel practice of stereotactic radiosurgery

JNSPG 75th Anniversary Invited Review Article

Douglas Kondziolka

S tereotactic radiosurgery has revolutionized the practice of neurological surgery and radiation oncology, and has had major implications in other specialties, such as medical oncology, neurotology, pain management, neurology, and neuroimaging. The publication record across many different disorders is large, comprehensive in scope, and long-term. 29 Concerns about secondary malignant transformation have been muted by long-term safety reports. 34 , 42 Radiation-related injury or adverse radiation effects sometimes seen as part of the expected tissue response

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underwent gamma knife radiosurgery were reviewed. The median age was 70 years (range 26–92 years). Most patients had typical features of trigeminal neuralgia, although 16 (7.3%) described additional atypical features. One hundred thirty-five patients (61.4%) had previously undergone surgery and 80 (36.4%) had some degree of sensory disturbance related to the earlier surgery. Patients were followed for a maximum of 6.5 years (median 2 years). Complete or partial relief was achieved in 85.6% of patients at 1 year. Complete pain relief was achieved in 64.9% of patients at

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Douglas Kondziolka

For years, surgeons and neurologists have debated the value of standard temporal lobe resections (mostly performed before 1996) compared with selective amygdalohippocampectomy (performed after 1995) in the management of temporal lobe epilepsy. This debate has raged due to comparisons on seizure outcome; morbidity; language; and cognitive, visual, and behavioral results. In this report, the authors compare a well-matched, noncontemporaneous cohort of patients with mesial temporal sclerosis who underwent surgery. 1 The average length of follow-up after

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Zane Schnurman and Douglas Kondziolka

, the developmental pathway in the United States is laid out from preclinical studies through Phase 3 randomized controlled trials by FDA regulations. Other countries use their own processes. But for other treatments, particularly surgeries, 2 the progression of a procedure to community acceptance is less clear. A significant challenge for investigating treatment development is the selection of an applicable end point that represents community acceptance for procedures that did not develop along a standard drug-based path. This report aims to demonstrate the theory

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Jason Sheehan, Douglas Kondziolka, John Flickinger and L. Dade Lunsford

records, phone interviews, direct neurological examination, and subjective reports from the patients themselves. The patient population consisted of four men and four women. Their average age was 55.5 years (range 32–88 years) and details are provided in Table 1 . Three patients had undergone craniotomy and subtotal resection, and one had undergone embolization. Gamma knife surgery was the initial treatment modality in the remaining four patients. Histological confirmation of the tumor was obtained at surgery in three patients and in five patients a clinical

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Beatriz E. Amendola and Aizik L. Wolf

T o T he E ditor : We read with interest the recently published article by Salvetti et al. 5 (Salvetti DJ, Nagaraja TG, McNeill IT, et al: Gamma Knife surgery for the treatment of 5 to 15 metastases to the brain. Clinical article. J Neurosurg 118: 1250–1257, June 2013). We were surprised that the authors omitted reference to our earlier work in the management of multiple brain metastases using Gamma Knife surgery (GKS), which was published in the Journal of Neurosurgery in 2002. 1 In that paper we reported on 72 patients with more than 10 brain

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Douglas Kondziolka

Yomo and colleagues 4 review the extensive vestibular schwannoma (VS) experience from Marseille. They paid special attention to the longitudinal audiometric data both before and after Gamma Knife surgery (GKS) in 154 patients with unilateral VS over an 8-year period. Their hypothesis was that radiosurgery would worsen the expected rate of hearing deterioration in a patient with VS in comparison with the natural course. Recently, there have been a number of articles on conservative management for VS that have included analyses of hearing loss. A recent

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John Y. K. Lee and Douglas Kondziolka

. Clinical Material and Methods Nineteen patients underwent placement of a thalamic Activa Tremor DBS system (Medtronic Inc., Minneapolis, MN) for management of ET between May 1997 and November 2003. All patients gave informed consent for the surgery. This study was conducted according to the Health Insurance Portability and Accountability Act and the University of Pittsburgh Internal Review Board guidelines. In all of these patients medical management of tremor, consisting of propranolol or Mysoline therapy, had failed and severe tremor was present, causing major