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Gamma knife radiosurgery for symptomatic brainstem intra-axial cavernous malformations
Seong-Hyun Park1, Sung-Kyoo Hwang
1Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.
World Neurosurgery
|September 27, 2012
Summary
Gamma Knife radiosurgery (GKRS) effectively reduced rebleeding in brainstem cavernous malformations (CMs). This treatment offers a safer alternative for high-risk patients, with a significant decrease in hemorrhage rates post-procedure.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Neurology
Background:
- Brainstem intra-axial cavernous malformations (CMs) pose significant surgical risks.
- Symptomatic CMs often lead to recurrent hemorrhages, impacting patient health.
- Gamma Knife radiosurgery (GKRS) is explored as a less invasive treatment option.
Purpose of the Study:
- To evaluate the efficacy and safety of GKRS for symptomatic brainstem intra-axial CMs.
- To assess the reduction in hemorrhage rates after GKRS.
- To determine the overall outcomes and potential side effects of GKRS in this patient cohort.
Main Methods:
- Twenty-one patients with symptomatic brainstem intra-axial CMs underwent GKRS.
- Median follow-up was 32 months post-radiosurgery.
- Median marginal radiation dose was 13 Gy for CM volumes of 0.56 mL.
Main Results:
- Pre-GKRS, the annual hemorrhage rate was 39.5%; post-GKRS, it decreased to 8.2% in the first two years, with only one hemorrhage observed.
- After the latency period, no further hemorrhages occurred.
- One patient (5%) developed permanent paresthesia, a new neurological symptom.
Conclusions:
- GKRS demonstrates relative effectiveness and safety in reducing rebleeding for brainstem intra-axial CMs with high surgical risk.
- Careful selection of low marginal doses and optimal radiosurgical techniques are crucial for favorable outcomes.
- GKRS presents a viable therapeutic option for carefully selected patients with these challenging lesions.
