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Updated: Aug 20, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Gamma knife surgery for multiple hemangioblastomas
Yong Sook Park1, Jong Hee Chang, Jin Woo Chang
1Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Object:
The authors describe their experience in treating patients with hemangioblastoma, especially multiple lesions, with gamma knife surgery (GKS).
Methods:
Nine patients with 84 hemangioblastomas underwent GKS between July 1992 and May 2003. Three patients harbored a single lesion and six patients had multiple lesions. Of the six patients with multifocal tumors, a diagnosis of von Hippel-Lindau disease had been established in five. In the patients with multiple lesions, the mean radiation dose delivered to the tumor margin was 16.6 Gy (range 12.8-29.75 Gy). The mean margin isodose was 60% (range 40-95%). Three of the 84 lesions failed to be controlled after a mean follow-up period of 4.3 years (range 8.6-141 months). One patient who had undergone two GKS treatments suffered delayed radiation-induced complications, and posterior fossa decompression and ventriculoperitoneal shunt insertion were required.
Conclusions:
To achieve tumor control and avoid morbidity, the surgeon should keep in mind minimizing field overlapping by using a small-diameter collimator or applying a steep dose gradient, and by accurate dose prescription.
