Journal of neurosurgery
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Journal of neurosurgery · Dec 2012
Case ReportsNew nidus formation adjacent to the target site of an arteriovenous malformation treated by Gamma Knife surgery.
New nidi are rarely found adjacent to the resection margin following treatment for an arteriovenous malformation (AVM), especially in adults. In addition, there are no reports in adults of new nidus formation adjacent to the targeted site of an AVM that angiography has verified to be completely obliterated by radiosurgery. The authors present their experience with recurrent AVMs following AVM radiosurgery in 3 patients whose ages were 9 years, 10 years, and 33 years. ⋯ Angiography performed after the first radiosurgery confirmed complete removal of the nidus in all 3 patients, and new nidus formation was detected 31, 132, and 36 months after the initial GKS. The new lesions were also treated by GKS. Occasionally, in patients with recurrent AVMs, such as those described in this paper, long-term clinical and angiographic follow-up may be required, even if complete occlusion is originally shown on angiograms.
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Gamma Knife surgery (GKS) is currently believed to be a safe and minimally invasive modality in the treatment of uveal melanomas. It could be used as an alternative treatment to enucleation, preserving the eyeball as well as visual function. The authors report their experiences with GKS for uveal melanomas for the period from February 1998 to December 2006. ⋯ Gamma Knife surgery provides excellent local control of uveal melanomas with a decrease in volume over time. This procedure not only preserves the eyeball and its potential visual function, but also decreases the potential for hematological dissemination and achieves sufficient local tumor control with a gradual reduction in volume.
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Journal of neurosurgery · Dec 2012
Brainstem cavernous malformations: the role of Gamma Knife surgery.
The authors retrospectively reviewed the efficacy and safety of Gamma Knife surgery (GKS) in patients with brainstem cavernous malformations (CMs). The CMs had bled repeatedly and placed the patients at high risk with respect to surgical intervention. ⋯ Gamma Knife surgery is effective in reducing the rate of recurrent hemorrhage. In the authors' experience, it was possible to control bleeding using a low-dose treatment. In addition, there were few symptomatic radiation-induced complications. As a result, the authors believe that GKS is a good alternative treatment for brainstem CMs.
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Journal of neurosurgery · Dec 2012
Reliability of contour-based volume calculation for radiosurgery.
Determining accurate target volume is critical for both prescribing and evaluating stereotactic radiosurgery (SRS) treatments. The aim of this study was to determine the reliability of contour-based volume calculations made by current major SRS platforms. ⋯ Significant variations in volume calculation were observed based on data obtained from the SRS systems that were investigated. This observation highlights the need for strict quality assurance and benchmarking efforts when commissioning SRS systems for clinical use and, moreover, when conducting multiinstitutional cross-SRS platform clinical studies.
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Journal of neurosurgery · Dec 2012
Case ReportsOverheated and melted intracranial pressure transducer as cause of thermal brain injury during magnetic resonance imaging: case report.
Magnetic resonance imaging is used with increasing frequency to provide accurate clinical information in cases of acute brain injury, and it is important to ensure that intracranial pressure (ICP) monitoring devices are both safe and accurate inside the MRI suite. A rare case of thermal brain injury during MRI associated with an overheated ICP transducer is reported. This 20-year-old man had sustained a severe contusion of the right temporal and parietal lobes during a motor vehicle accident. ⋯ Scanning conditions--including configuration of the transducer, MRI parameters such as the type of radiofrequency coil, and the specific absorption rate limit--deviated from the manufacturer's recommendations. In cooperation with the manufacturer, the authors developed a precautionary tag describing guidelines for safe MR scanning to attach to the display unit of the product. Strict adherence to the manufacturer's guidelines is very important for preventing serious complications in patients with ICP monitors undergoing MRI examinations.