Journal of neurosurgery
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Journal of neurosurgery · Dec 2014
Gamma Knife surgery for arteriovenous malformations within or adjacent to the ventricles.
The outcomes of stereotactic radiosurgery for arteriovenous malformations (AVMs) within or adjacent to the ventricular system are largely unknown. This study assessed the long-term outcomes and hemorrhage risks for patients with AVMs within this region who underwent Gamma Knife surgery (GKS) at the University of Pittsburgh. ⋯ Although patients in this study demonstrated an elevated hemorrhage risk that remained until complete obliteration, GKS still proved to be a generally safe and effective treatment for patients with these high-risk intraventricular and periventriclar AVMs.
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Journal of neurosurgery · Dec 2014
Case ReportsGamma Knife surgery for treating brain metastases arising from hepatocellular carcinomas.
Brain metastases from hepatocellular carcinoma (HCC) are rare, and the evidence of the effectiveness of Gamma Knife surgery (GKS) in this disease is lacking. The authors report their institutional experience with GKS in patients with brain metastases from HCCs. ⋯ Although survival was extremely poor in patients with brain metastases from HCCs, GKS showed acceptable local tumor control at 3 months after the treatment. The authors suggest that GKS represents a noninvasive approach that may provide a valuable option for treating patients with brain metastases from HCCs.
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Journal of neurosurgery · Dec 2014
Spinal cerebrospinal fluid leak as the cause of chronic subdural hematomas in nongeriatric patients.
The etiology of chronic subdural hematoma (CSDH) in nongeriatric patients (≤ 60 years old) often remains unclear. The primary objective of this study was to identify spinal CSF leaks in young patients, after formulating the hypothesis that spinal CSF leaks are causally related to CSDH. ⋯ The direct proof of spinal CSF leakage in 25.9% of patients suggests that spinal CSF leaks may be a frequent cause of nongeriatric CSDH.
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Journal of neurosurgery · Dec 2014
Microsurgery for vestibular schwannoma after Gamma Knife surgery: challenges and treatment strategies.
Resection of vestibular schwannoma (VS) after Gamma Knife surgery (GKS) is infrequently performed. The goals of this study were to analyze and discuss the neurological outcomes and technical challenges of VS resection and to explore strategies for treating tumors that progress after GKS. ⋯ For the few VS cases that require resection after radiosurgery, maximal tumor resection can be achieved with modern skull-based techniques and refined neuromonitoring without affecting facial nerve function.
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Journal of neurosurgery · Dec 2014
Comparative StudyComparison of radiation dose spillage from the Gamma Knife Perfexion with that from volumetric modulated arc radiosurgery during treatment of multiple brain metastases in a single fraction.
The objective of this study was to examine radiation dose distributions created by 2 competing radiosurgery modalities for treating multiple brain metastases: single-isocenter volumetric modulated arc radiosurgery (VMAS) and Gamma Knife Perfexion (GKP). In addition, the effectiveness of multiple radiosurgery quality metrics was evaluated and compared between these advanced treatment modalities. ⋯ Stereotactic radiosurgery plans for the treatment of multiple metastases with VMAS delivered significantly more dose to the normal brain tissues than plans for GKP. Radiosurgery quality metrics including a measure of the dose gradient are better suited to providing contrast between modern radiosurgery treatment platforms.