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Wen-Yuh Chung, David Hung-Chi Pan, Cheng-Ying Shiau, Wan-Yuo Guo, and Ling-Wei Wang

in coronal T 1 -weighted MR images (A and B). Before GKS, hydrocephalus and poor consciousness was corrected by placement of a ventriculoperitoneal shunt, followed by stereotactic aspiration of the large cyst (arrow) and Ommaya reservoir implantation. C and D: Images revealing that the tumor volume has decreased to 6 cm 3 , which is suitable for GKS. E and F: Images revealing the tumor response to a 12-Gy margin dose. The tumor volume shrank to 0.7 cm 3 6 months after GKS. Gamma Knife Radiosurgery Gamma knife radiosurgery was used as the initial

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Masahiro Izawa, Motohiro Hayashi, Kohtarou Nakaya, Hiroyuki Satoh, Taku Ochiai, Tomokatsu Hori, and Kintomo Takakura

normalization of endocrinopathies. If patients are not able to undergo resection in a state of general anesthesia because of age or poor general medical condition, GKS may be recommended as a primary treatment alternative to surgical resection. Gamma knife radiosurgery for pituitary adenomas has been shown to be a safe and effective treatment. 9 This investigation was conducted to evaluate the clinical results of GKS and its efficacy and safety in the treatment of pituitary adenomas. Clinical Material and Methods Patient Population One hundred eight of the 1490

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E. J. St. George, J. Kudhail, J. Perks, and P. N. Plowman

predictors for the development of acute complications. Clinical Material and Methods Sixty-five patients with intracranial lesions were treated with the gamma knife (model B) between September 2000 and October 2001. Adverse events following radiosurgery were recorded prospectively by means of a telephone interview within 2 to 3 weeks of the procedure. Immediate adverse events were defined as any new or unexpected symptom developing within 2 weeks of treatment and were graded as mild, moderate, or severe. Mild symptoms were defined as those requiring no advice and

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Andrew G. Shetter, C. Leland Rogers, Francisco Ponce, Jeffrey A. Fiedler, Kris Smith, and Burton L. Speiser

return at a later date. When this occurs, repeated GKS is a treatment consideration. We report our experience in the treatment of 19 patients with TN who elected to undergo a second gamma knife procedure. Clinical Material and Methods Patient Population A total of 240 patients with TN were treated bewteen March 1997 and March 2002. Twenty-nine patients underwent a second GKS, either because of inadequate pain relief following an initial GKS or a delayed pain recurrence. Their outcomes were assessed by a standardized mailed questionnaire, in which they were

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Nan Zhang, Li Pan, Bin Jiang Wang, En Min Wang, Jia Zhong Dai, and Pei Wu Cai

cerebrovascular malformations and develop in approximately 0.4 to 0.8% of the population. 9 Gamma knife radiosurgery had already been used for cavernous hemangiomas before 1990. 12 Kondziolka, et al., 7 had suggested that GKS could reduce the annual rate of hemorrhage. A high incidence of adverse radiation effects after GKS for cavernous hemangiomas had also been reported, 4 and radiosurgery for cavernous hemangiomas remains controversial. 1, 2 A Leksell gamma knife unit was installed at our institution in 1993. By 1996, we had become concerned that the incidence of

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Nan Zhang, Li Pan, Jia Zhong Dai, Bin Jiang Wang, En Min Wang, and Pei Wu Cai

foramen schwannomas treated with radiosurgery supports the use of this method. 5–8 The purpose of this investigation was to evaluate the effect of GKS on tumor growth and symptom relief in patients with jugular foramen schwannomas. Clinical Material and Methods Patient Population Between November 1993 and December 2000, 57 patients with jugular foramen tumors underwent radiosurgical treatment with the Leksell Gamma Knife (Elekta Instruments, Stockholm, Sweden). Twenty-seven of these tumors were jugular foramen schwannomas. The details of GKS in 27 patients

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Vilibald Vladyka, Roman Liščk, Oldřich Šubrt, Jozef Vymazal, Jiri Pilbauer, Iveta Hejduková, and Pavel Němec

is covered by the 50% isodose. To achieve this the maximum dose has to be targeted inside the vitreous body. The Leksell gamma knife is used for the radiation. As there was no available experience with this kind of treatment in glaucoma we started with a small targeted volume in painful and blind glaucomatous eyes, which would otherwise be enucleated. A part of the ciliary body was irradiated with a margin dose of 14 Gy to the 50% isodose ( Fig. 1 ). As this procedure was well tolerated and the clinical symptoms were ameliorated, the method was also applied to

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Mika Niemelä, Young Jin Lim, Michael Söderman, Juha Jääskeläinen, and Christer Lindquist

safer in eloquent areas in terms of radiation injury; 2) shrink the tumor or at least stop its growth in the long run; and 3) prevent expansion or formation of cysts. Radiosurgery is apparently superior in terms of reduced hospital stay and immediate costs, but years of follow-up review and possible surgery later may result in a different total. So far, there are published data on only five hemangioblastoma patients treated with radiosurgery. 1, 11 We analyzed the long-term outcome of all 10 hemangioblastoma patients treated by gamma knife surgery at the Karolinska

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Satoshi Suzuki, Junichi Omagari, Shunji Nishio, Eiichiro Nishiye, and Masashi Fukui

metastatic brain tumors is investigated. We focused on patients in whom the number of the tumors was 10 or more. Clinical Material and Methods Twenty-four patients with 10 or more simultaneous multiple brain metastases underwent GKS in the Shin-Koga Hospital Gamma Knife Center between July 1998 and January 2000. None had received whole-brain radiation therapy prior to GKS. There were 13 women and 11 men, with a mean age of 58.3 years (range 40–78 years). The primary sites of the tumors were lung in 20 patients, breast in three, and colon in one. The mean number of

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Jörgen Boëthius, Elvar Ulfarsson, Tiit Ráhn, and Bodo Lippitz

administered in the pediatric patients; in older patients, a local anesthetic was supplemented with light sedation. Intravenous paramagnetic contrast—enhanced stereotactic MR imaging, or in some cases CT scanning, was performed for target coordinate determination and dose planning. A Cobalt-60 Gamma Knife (Elekta Instrument AB, Stockholm, Sweden) was used for GKS. During the course of the study the equipment and software were updated several times. In some of the early cases the dose planning system at the time of GKS did not permit the determination of the prescription dose