Journal of neurosurgery
-
Journal of neurosurgery · Dec 2012
Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma.
The aim of this study was to assess long-term clinical outcomes in patients who underwent Gamma Knife surgery (GKS) with a low margin dose-14 Gy or less-to treat vestibular schwannoma (VS) unrelated to neurofibromatosis Type II. ⋯ With a low prescribed margin dose of 14 Gy or less, GKS was confirmed to provide long-term tumor control for small to medium-sized VSs and largely to prevent cranial nerves from iatrogenic injury. Based on the findings of this study, GKS is also a reasonable option for the treatment of large, heterogeneously enhancing tumors without symptomatic brainstem compression. Gamma Knife surgery can preserve a high quality of life for most patients with VS who do not have symptomatic brainstem compression. Long-term follow-up is required because of the risk of delayed recurrence of VS.
-
Journal of neurosurgery · Dec 2012
High-precision volume-staged Gamma Knife surgery and equivalent hypofractionation dose schedules for treating large arteriovenous malformations.
The goal of this study was to develop a technique for performing submillimeter high-precision volume-staged Gamma Knife surgery and investigate its potential benefits in comparison with hypofractionated stereotactic radiotherapy (SRT) for treating large arteriovenous malformations (AVMs). ⋯ Volume staging remains advantageous over hypofractionation in delivering a higher dose to the target and for better sparing of normal brain tissue in the treatment of large AVMs. More clinical data are needed, however, to justify the clinical superiority of this increased dose when compared with a hypofractionated treatment regimen.
-
Journal of neurosurgery · Dec 2012
Quantitative analysis of movement of a cervical target during stereotactic radiosurgery using the Leksell Gamma Knife Perfexion.
The design of the Leksell Gamma Knife Perfexion facilitates stereotactic radiosurgery (SRS) on cervical spine targets provided that the target itself is located superior to the standard G stereotactic head frame base ring and does not move. This study was designed to measure potential deviations of targets in the upper cervical spine while using the currently available Leksell Coordinate Frame G. ⋯ Target deviation grossly exceeded clinical tolerance and was greater the farther the distance between the cranial base and the cervical spine target. Simple and reproducible methods that allow SRS centers to immobilize the patient's cervical spine using the currently available model G head frame are necessary to increase the range of targets that can be treated safely using the Leksell Gamma Knife Perfexion.
-
Journal of neurosurgery · Dec 2012
Same-day stereotactic aspiration and Gamma Knife surgery for cystic intracranial tumors.
The goal of this study was to evaluate the efficacy and safety of same-day stereotactic aspiration and Gamma knife surgery (GKS) for cystic intracranial tumors. ⋯ The same-day stereotactic aspiration and GKS procedure was safe in patients with cystic brain tumors. Prompt symptom relief was obtained after cyst aspiration. The decrease in tumor volume following aspiration made GKS more effective because a higher prescription dose could be administered with a lower possibility of radiation-induced side effects.
-
Journal of neurosurgery · Dec 2012
Dose-dependent facilitation of peripheral nerve regeneration by bone marrow-derived mononuclear cells: a randomized controlled study: laboratory investigation.
Bone marrow-derived stem cells enhance the rate of regeneration of neuronal cells leading to clinical improvement in nerve injury, spinal cord injury, and brain infarction. Recent experiments in the local application of bone marrow-derived mononuclear cells (BM-MNCs) in models of sciatic nerve transection in rats have suggested their beneficial role in nerve regeneration, although the effects of variable doses of stem cells on peripheral nerve regeneration have never been specifically evaluated in the literature. In this paper, the authors evaluated the dose-dependent role of BM-MNCs in peripheral nerve regeneration in a model of sciatic nerve transection in rats. ⋯ This study emphasizes the role of BM-MNCs, which can be isolated easily from bone marrow aspirates, in peripheral nerve injury and highlights their dose-dependent facilitation of nerve regeneration.