Adverse Radiation Effects.
Authors: Cheok SK, Chiang VL
Abstract
Here we discuss the low risk of radiation-related complications after Leksell radiosurgery, as well as its diagnosis and management. Using multimodality imaging in the context of clinical suspicion of radiation injury clinicians can now start management with agents designed to reduce the progression of radiation vasculopathy. In more severe cases both medical and surgical management options can be offered.
PMID: 31096237 [PubMed - as supplied by publisher] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Non-Vestibular Schwannoma Radiosurgery.
Authors: Peker S
Abstract
There is a growing body of studies regarding the effects of Gamma Knife radiosurgery on vestibular schwannomas. However, due to their rare presence and variability, our experience with the management of non-vestibular schwannomas is relatively limited. Management strategies include radiological monitoring, microsurgical resection, microsurgery combined with radiosurgery, or upfront radiosurgery. The lack of large series and heterogeneous data makes it difficult to suggest a definitive treatment strategy and management should be tailored for each patient's radiological and clinical...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Guidelines for Multiple Brain Metastases Radiosurgery.
Authors: Niranjan A, Monaco E, Flickinger J, Lunsford LD
Abstract
Stereotactic radiosurgery (SRS) is an effective treatment for patients with multiple brain metastases. Three decades of increasingly powerful scientific studies have shown that SRS improves outcomes and reduces toxicity when it replaces whole-brain radiation therapy (WBRT). Expert opinion surveys of clinicians have reported that the total intracranial tumor volume rather than the number of brain metastases is related to outcomes. As a result, an increasing number of treating and referring physicians have replaced the reflex use of WBRT with ...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Stereotactic Radiosurgery for Patients with 10 or More Brain Metastases.
Authors: Yamamoto M, Higuchi Y, Sato Y, Aiyama H, Kasuya H, Barfod BE
Abstract
The JLGK0901 study showed the non-inferiority of stereotactic radiosurgery (SRS) alone as the initial treatment for 5-10 as compared to 2-4 brain metastases (BM) in terms of overall survival and most secondary endpoints [Lancet Oncol 2014;15:387-395]. A trend for patients with 5-10 tumors to undergo SRS alone has since become apparent. The next step is to reappraise whether results of SRS treatment alone for tumor numbers ≥10 differ from those for 2-9 tumors. During the past 2 decades, several retrospective studies have demons...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Trigeminal Neuralgia and Other Facial Neuralgias.
Authors: Wolf A, Kondziolka D
Abstract
Radiosurgery is an effective treatment approach for the management of type 1 trigeminal neuralgia (TN), comparable to other ablative techniques. Also, radiosurgery can effectively treat TN secondary to other causes, including multiple sclerosis, tumor-related TN, as well as other craniofacial neuralgias in select cases with minimal complications. An increasing number of patients favor radiosurgery over other more invasive approaches in order to avoid a general anesthetic, a prolonged hospital stay, and a higher risk of complications.
PMID: 31096245 [PubMed - a...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Gamma Knife Radiosurgery of Arteriovenous Malformations: Long-Term Outcomes and Late Effects.
Authors: Pollock BE
Abstract
Gamma Knife radiosurgery (GKRS) of cerebral arteriovenous malformations (AVM) is an accepted treatment option that has been performed for more than 40 years. The goal of AVM GKRS is nidus obliteration to eliminate the risk of intracranial hemorrhage while minimizing the risk of short- and long-term adverse radiation effects (ARE). Nidus obliteration typically occurs between 1 and 5 years after GKRS. The most important factor associated with nidus obliteration is the prescribed radiation dose. The chance of obliteration ranges from 60 to 70% for margin doses of 15-16 Gy to 90% o...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Gamma Knife Radiosurgery for Meningioma.
Authors: Flannery T, Poots J
Abstract
Since its first reported use in 1976 in Sweden, Gamma Knife (GK) radiosurgery has become an accepted treatment option for intracranial meningioma, either upfront, in combination with planned subtotal resection, or as adjuvant/salvage treatment. Initially, GK was used in patients unfit for a major surgical procedure or for high-risk meningiomas adjacent to critical neurovascular structures. However, with the availability of larger and increasingly long-term follow-up studies, the proven durability of GK in the treatment of meningiomas means that it has become a treatmen...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Leksell Radiosurgery for the 3 H Tumors: Hemangiomas, Hemangioblastomas, and Hemangiopericytomas.
Authors: Johnson S, Niranjan A, Kano H, Lunsford LD
Abstract
Leksell stereotactic radiosurgery has proven to be effective for less common tumors encountered in the brain, including hemangiomas of the orbit or cavernous sinus, recurrent hemangiopericytomas, and both sporadic hemangioblastomas as well as those encountered in the context of von Hippel-Lindau (VHL) disease. While all three tumors are responsive to single-session radiosurgery, hemangiomas and hemangiopericytomas are the most likely to demonstrate tumor regression. Hemangiopericytomas that recur after initial resection can be lower grade or anap...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Radiosurgery for Glomus Tumors.
Authors: Lee CC, Trifiletti DM, Sheehan JP
Abstract
Glomus tumors of the head and neck typically compress adjacent blood vessels and cranial nerves and result in varied clinical presentations. Moreover, they are seldom encountered, even at large medical centers, and specialists in neurosurgery, otolaryngology, and radiation oncology have yet to reach a generalized consensus regarding the optimal management approach. In an effort to summarize the available data and better elucidate optimal treatment and management strategies for glomus tumors, we conducted a review of the published literature on this topic ...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Stereotactic Radiosurgery for Low-Grade Gliomas.
Authors: Niranjan A, Faramand A, Lunsford LD
Abstract
Low-grade gliomas represent a heterogeneous group of tumors. The goals of treatment include prolonged survival and reduced morbidity. Treatment strategies vary depending upon tumor histology, anatomic location, age, and the general medical condition of the patient. Safe surgical resection remains the first choice for the treatment of resectable tumors. In cases of unresectable lesions, adjuvant radiotherapy and chemotherapy are considered. Several reports in recent years have documented the safety and effectiveness of stereotactic radiosurgery (SRS) in ...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Leksell Stereotactic Radiosurgery for Cavernous Malformations.
Authors: Lunsford LD, Niranjan A, Kano H, Monaco Iii EA, Flickinger JC
Abstract
Cavernous malformations (CM) represent a distinct subgroup of brain vascular malformations that are characterized by small sinusoidal vascular channels with hyaline degeneration and old blood pigments. Because of the increasing availability of magnetic resonance imaging (MRI) they are detected much more frequently in the present era. CM may be solitary or found in the context of a familial variant that results in an increasing number of CM developing as the patient ages. Because of the variable risk of subacute bleeding, their ...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Salvage Leksell Stereotactic Radiosurgery for Malignant Gliomas.
Authors: Niranjan A, Kano H, Monaco Iii EA, Lunsford LD
Abstract
The outcome of patients with malignant gliomas has not substantially improved, even with advances in imaging, neurosurgery, molecular subtyping, and radiation, and newer oncologic options. Maximal safe resection when feasible remains the initial treatment of choice for most malignant gliomas. These tumors often recur and require additional therapy to control the tumor growth. Leksell stereotactic radiosurgery (SRS) is offered as salvage therapy in patients with recurrent or residual malignant gliomas. SRS is well tolerated and is associated w...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Radiosurgery for Central Neurocytoma.
Authors: Nakamura A, Kano H, Niranjan A, Lunsford LD
Abstract
The classification of central neurocytoma (CN) by the WHO was upgraded to grade 2 in 1993 as it was recognized that at least some of these tumors can exhibit more aggressive behavior. Currently, as of 2016, CN is classified as WHO grade 2. Indeed, some atypical variants have been reported and residual postsurgical tumor is believed to have the potential for malignant transformation. Although gross total resection is usually curative for CN (5-year survival rate 99%), it is achieved in nearly 30-50% of cases due to its central location. Adjuvant ...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Radiosurgery for Dural Arteriovenous Fistulas.
Authors: Yang HC, Lee CC, Pan DHC, Chung WY
Abstract
Intracranial dural arteriovenous fistulas (DAVFs) are abnormal arteriovenous connections within the dura, in which meningeal arteries shunt blood directly into the dural sinus or leptomeningeal veins. Among all the treatment options for the treatment of DAVFs, stereotactic radiosurgery (SRS) is a safe and effective modality. SRS provides a minimally invasive therapy for patients who harbor less aggressive DAVFs without cortical vein drainage (CVD), but who suffer from intolerable headache, bruit, or ocular symptoms. For more aggressive DAVFs with CVD ass...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Preface.
Authors: Lunsford LD, Niranjan A, Kano H
PMID: 31096258 [PubMed - as supplied by publisher] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
