Journal of neurosurgery
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Journal of neurosurgery · Jan 2005
Case ReportsCyst formation following gamma knife surgery for intracranial meningioma.
The authors conducted a study to evaluate the clinical significance of cyst formation or enlargement after gamma knife surgery (GKS) for intracranial benign meningiomas. ⋯ New cyst formation following GKS for benign intracranial meningioma is relatively rare; however, both preexisting and newly developed cysts tend to enlarge after GKS and often require surgery.
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Journal of neurosurgery · Jan 2005
Microsurgical anatomy of cerebral revascularization. Part I: anterior circulation.
Revascularization is an important component of treatment for complex aneurysms that require parent vessel occlusion, skull base tumors that involve major vessels, and certain ischemic diseases. In this study, the authors examined the microsurgical anatomy of cerebral revascularization in the anterior circulation by demonstrating various procedures for bypass surgery. ⋯ It is important to understand the methods of bypass procedures and to consider indications in which cerebral revascularization is needed.
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Journal of neurosurgery · Jan 2005
Case ReportsTemporary symptomatic swelling of meningiomas following gamma knife surgery. Report of two cases.
In two patients in whom gamma knife surgery was performed for meningiomas clinically significant volume increases were observed in the first 3 months after treatment. Clinical examination and various imaging studies form the basis of the report in these patients. In each case, the volume increase was temporary.
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Journal of neurosurgery · Jan 2005
Case ReportsHistopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation.
Stereotactic radiosurgery is a controversial treatment modality in the management of cerebral cavernous hemangiomas (CHs), and results vary from center to center. Even the interpretation of treatment failure is controversial. It is suggested that the systematic pathological investigation of irradiated specimens could help to resolve the controversy. ⋯ Compared with nonirradiated control CH tissue samples, there was endothelial cell destruction and marked fibrosis with scar tissue formation in the stroma of the treated lesion. The histopathological findings in this specimen were similar to those described in arteriovenous malformations after gamma knife surgery. The results of light microscopic investigations suggest that the ionizing effect of radiation energy evokes vascular and connective tissue stroma changes in CHs as well.
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The authors reviewed their 14-year experience using stereotactic radiosurgery for the treatment of hemangioblastomas and define the role and the proper strategy for radiosurgery of this condition. ⋯ Gamma knife surgery is a safe and effective method to control hemangioblastomas for as many as 10 years. Higher doses and smaller tumors probably contribute to good outcomes. Recurrence outside the original irradiated area is common. Peritumoral contrast enhancement may be seen in larger tumors. The authors recommend regular imaging follow up and early repeated treatment in the face of new or growing tumors.