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Complications after gamma knife radiosurgery for benign meningiomas

Authors
 J Chang  ;  J Choi  ;  S Chung  ;  Y Park 
Citation
 JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, Vol.74(2) : 226-230, 2003 
Journal Title
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
ISSN
 0022-3050 
Issue Date
2003
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Edema/diagnosis ; Brain Edema/surgery ; Child ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms/diagnosis ; Meningeal Neoplasms/surgery* ; Meningioma/diagnosis ; Meningioma/surgery* ; Middle Aged ; Neurologic Examination ; Outcome Assessment (Health Care) ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology* ; Radiosurgery* ; Retrospective Studies
Keywords
12531956
Abstract
Objectives: To analyse the results of gamma knife radiosurgery (GKS) for the trreatment of intracranial meningiomas and to assess possible factors related to the outcome and complications of such treatment.

Methods: The authors retrospectively reviewed the clinical and radiological data of 179 patients (194 lesions) treated with GKS for meningiomas between May 1992 and October 2000. The mean follow up duration was 37.3 months (range 6.4 to 86.3 months). The study determined the correlation between radiosurgical outcome including imaging changes after GKS and multiple factors such as tumour location and size, patient characteristics, venous sinus status, pre-GKS degree of oedema, other treatment modalities, and radiosurgical parameters.

Results: The radiological control rate was 97.1%. Magnetic resonance imaging (MRI) showed complications after GKS in 35 lesions (25.0%) among the 140 lesions followed up with MRI. Complications were divided into peritumorous imaging changes (33 lesions; 23.6%) and transient cranial nerve dysfunction (two lesions; 1.4%). Radiation induced imaging changes were seen mostly in convexity, parasagittal, and falx meningiomas that were deeply embedded in the cortex. About 60% of these were asymptomatic and the overall rate of symptomatic imaging changes was 9.3%. Neurological deficit related to imaging changes developed in only three patients, and all the symptoms were transient.

Conclusion: GKS for intracranial meningiomas seems to be a safe and effective treatment. However, meningiomas of the convexity, parasagittal region, or falx cerebri have a higher incidence of peritumorous imaging changes after GKS than those of the skull base. Therefore, the use of GKS needs to be considered very cautiously in cerebral hemispheric meningiomas, taking into consideration patient age and general condition, tumour size and location, pattern of cortical embedding, relation between the tumour and venous sinuses, presenting symptoms, and patient preference.
Files in This Item:
T200302934.pdf Download
DOI
10.1136/jnnp.74.2.226
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Gou(박용구)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Chung, Sang Sup(정상섭)
Choi, Jae Young(최재영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113410
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