Journal of neurosurgery
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Journal of neurosurgery · Jan 2005
Gamma knife thalamotomy for movement disorders: evaluation of the thalamic lesion and clinical results.
The authors studied the effects of gamma knife thalamotomy (GKT) on Parkinson disease-related tremor and essential tremor before and after reloading of radioactive cobalt. ⋯ The shorter delay in clinical improvement and smaller lesion size may be related to an increased radiation dose.
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Journal of neurosurgery · Jan 2005
Microsurgical anatomy of cerebral revascularization. Part II: posterior circulation.
Revascularization is an important component of treatment for complex aneurysms, skull base tumors, and vertebrobasilar ischemia in the posterior circulation. In this study, the authors examined the microsurgical anatomy related to cerebral revascularization in the posterior circulation and demonstrate various procedures for bypass surgery. ⋯ Although a clear guideline for cerebral revascularization procedures has not yet been established, it is important to understand various microsurgical techniques and their related anatomical structures. This will help surgeons consider surgical indications for treatment of patients with vertebrobasilar ischemia caused by aneurysms, tumors, or atherosclerotic diseases in the posterior circulation.
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Journal of neurosurgery · Jan 2005
Computational model for the estimation of the extracranial doses received during Leksell gamma knife model C treatment.
Extracranial doses received by patients undergoing Leksell gamma knife surgery (GKS) can be of clinical concern. Therefore, the ability to preestimate peripheral doses received outside the treatment field during the GKS would be beneficial and could be used for the optimization of treatment planning by providing a reference for practitioners to calculate the extracranial dose burden to the body before the start of treatment. ⋯ The peripheral dose depended on the collimator size with a logarithmic dependence on collimator size and a linear dependence on the number of shots. This model can be used for the estimation of peripheral doses with a total error less than 20%. This information can help clinicians with treatment planning optimization, especially in patients with long survival expectancy.
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Journal of neurosurgery · Jan 2005
Late cyst formation following gamma knife surgery of arteriovenous malformations.
The authors present data concerning the development of cysts following gamma knife surgery (GKS) in 1203 consecutive patients with arteriovenous malformations (AVMs) treated by the senior author (L.S.). The cyst was defined as a fluid-filled cavity at the site of a treated AVM. Cases involving regions corresponding to previous hematoma cavities were excluded. The incidence of cyst formation was assessed using magnetic resonance imaging studies performed in 196 cases with more than 10 years of follow up, in 332 cases with 5 to 10 years of follow up, and in 675 cases with less than 5 years of follow up. One hundred five cases were lost to follow-up study. The Cox regression method was used to analyze the factors related to cyst formation. ⋯ Overall, the incidence of cyst formation in patients who underwent GKS for AVM was 1.6%. The development of the cyst was related to the duration of the follow-up period. When cysts are symptomatic, surgical intervention should be performed.
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Complete resection is the optimal treatment for atypical meningiomas (AMs) but its feasibility depends on the tumor site. The object of this study was to assess the effect of gamma knife surgery (GKS) on AM. ⋯ After early tumor shrinkage, high recurrence rates were demonstrated both at the treatment margin and at distant locations in cases treated for AM. There was only one recurrence within the GKS radiation field. For small- and medium-sized AMs GKS may be a safe adjunct to other treatment modalities.