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Gamma Knife surgery–induced meningioma

Report of two cases and review of the literature

Jason Sheehan, Chun PO Yen, and Ladislau Steiner

S ince April 1970, the Gamma Knife has become an increasingly important neurosurgical tool in the treatment of AVMs. 13 , 21 , 28 Because of its minimally invasive nature and its precision, radiosurgery is associated with a low morbidity rate and essentially a 0% mortality rate. Rare instances of a serious complication, however, do occur. An attempt to contact 2500 patients with AVMs that were treated with GKS by the senior author (L.S.) has thus far yielded follow-up data on 1333 patients. During a retrospective examination of cases in which there was

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Dusan Urgosik and Roman Liscak

other areas of functional neurosurgery, namely movement disorders, psychiatric disorders, and epilepsy. Choosing an ablative procedure to treat functional disorders has become somewhat looked down upon by some professional groups. Nevertheless, there has been a renaissance in lesional interventions in recent years, 1 , 8 , 10 including the use of Gamma Knife surgery (GKS) for the treatment of various functional disorders. 11 , 15 The treatment of functional disorders by GKS is actually a partial return to the root of this method. 11 , 15 Functional radiosurgical

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Douglas Kondziolka, Joseph G. Ong, John Y. K. Lee, Robert Y. Moore, John C. Flickinger, and L. Dade Lunsford

limb. The VIM was targeted as follows: 1) anterior–posterior (1/4 of the AC–PC distance plus 1 mm anterior to the PC); 2) laterality (1/2 the width of the third ventricle plus 11 mm from the AC–PC line); and 3) superior–inferior (isocenter placed 2.5 mm superior to the AC–PC line). The laterality of the isocenter was adjusted to keep it medial to the internal capsule. The 20% isodose line of the 4-mm collimator was kept medial to the internal capsule. When the Model B or C Gamma Knife was used, selective beam blocking was performed to restrict the dose toward the

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Cheng-Loong Liang, Kang Lu, Po-Chou Liliang, and Han-Jung Chen

between March 2005 and August 2005. Gamma Knife Surgery Gamma Knife surgery was performed following the administration of a local anesthetic agent. After a Leksell model G stereotactic frame (Elekta AB) had been affixed to the head, each patient underwent stereotactic MR imaging to identify the tumor, optic nerve, and optic chiasm. Magnetic resonance imaging was performed in axial planes by using short repetition time sequences. Targeting was based on the axial images. The sequences were performed at 1-mm slice intervals. These imaging sequences provided graphic

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Aurelia Kollová, Roman Liščák, Josef Novotný Jr., Vilibald Vladyka, Gabriela Šimonová, and Ladislava Janoušková

adverse effects are still being discussed. 22 , 38 , 57 , 65 , 74 In this study we gathered information drawn from a large cohort of patients with a median follow-up of 60 months. Clinical Material and Methods Between 1992 and 2005, 1149 patients with meningiomas were treated using the Leksell Gamma Knife at the Na Homolce Hospital, Prague. This number represents 17.4% of all treated patients at this center. For the purposes of this study, 368 patients harboring 400 meningiomas treated between 1992 and December 31, 1999, were evaluated. Patients with atypical and

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Chun Po Yen, Jason Sheehan, Greg Patterson, and Ladislau Steiner

. Gamma Knife surgery, which was originally designed for deep-seated, well-defined, benign intracranial targets, has emerged as an alternative treatment. Clinical Material and Methods Patient and Tumor Characteristics Between March 1989 and March 2005, 53 patients with metastatic brainstem tumors were treated with GKS at the University of Virginia Health System’s Lars Leksell Center for Gamma Surgery ( Table 1 ). The study population consisted of 24 men and 29 women, with a mean age of 57.3 years (range 33–79 years). The primary malignancy was lung cancer in

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Corbin A. Helis, Emory McTyre, Michael T. Munley, J. Daniel Bourland, John T. Lucas Jr., Christina K. Cramer, Stephen B. Tatter, Adrian W. Laxton, and Michael D. Chan

heterogeneous patient population with multiple possible causes of symptoms. 5 , 10 , 20 Furthermore, because of the subset of patients with bilateral TN who have potential nonvascular etiology of their pain (such as MS and Charcot-Marie-Tooth [CMT] disease, which has been associated with bilateral TN), 27 it has been unclear whether the standard treatment options remain effective for this population. Gamma Knife radiosurgery (GKRS) is a widely accepted, noninvasive treatment option for medically refractory unilateral TN. Multiple large series have reported pain relief rates

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David Weintraub, Chun-Po Yen, Zhiyuan Xu, Jesse Savage, Brian Williams, and Jason Sheehan

cystic components, increased in size consistently. Patients with increases in the solid or cystic components who required operative intervention were also considered to have evidence of progression. Gamma Knife Surgery Technique The GKS procedure used in our institution has been described elsewhere. 9 In pediatric patients, it is our standard practice to perform frame placement and radiosurgical treatment after induction of general anesthesia. Magnetic resonance imaging was used for all cases except 2 treated in 1989, in which CT was used. Treatment was

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Tak Lap Poon, Samuel Cheong Lun Leung, Christopher Yee Fat Poon, and Chung Ping Yu

stereotactic modality, delivers focal and precise radiation to the target in a single session and minimizes exposure of surrounding normal brain tissues to radiation. 6 , 11 In this article, we evaluate our experience in using GKS as adjuvant therapy in patients with acromegaly and analyze factors related to biochemical remission. Methods We retrospectively reviewed data spanning the period 1997–2008 in the Gamma Knife statistics database at our hospital. All patients with active acromegaly who underwent GKS were included. Tumor sizes and hormone levels before and

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Dong Wan Kang, Sung Chul Lee, Yong Gou Park, and Jong Hee Chang

safe and minimally invasive treatment modality for these lesions. Gamma Knife surgery can preserve the eyeball and visual acuity on one side, even if it is impossible to preserve it on the other side. The purpose of the present study was to describe our treatment protocol and evaluate the results of GKS in 22 patients treated for uveal melanoma between February 1998 and December 2006. Methods Patient Characteristics We retrospectively reviewed the medical records of 22 patients with uveal melanoma who consecutively underwent GKS between February 1998 and