Gamma Knife Radiosurgery For Intracranial Cavernous Angiomas

Objective:To evaluate and analyze the therapeutic effect of Gamma knife radiosurgery and clinical outcome in patients with intracranial cavernous angiomas.Methods:The medical records of122patients who underwent radio-surgery at our institute were reviewed retrospectively. The number of the lesions they have totally was146and134of them were treated by Gamma knife surgery. Multi-isocenter dose planning was applied with a prescription dose of12～25Gy and40%～90%isodose located at the lesion margin. The central dose ranged from16.67to53.33Gy(mean30.5Gy). The average follow-up period was43months and the total follow-up period was437patient-years.Results:(1) In patients with epilepsy,40(83.3%) showed alleviation of seizures. In patients with lesions in the temporal lobe, the epilepsy alleviation rate was58.8%(10/17) which was lower than other groups but was no significant difference compared with other patients(P>0.05). There was no significant difference between groups with different peripheral dose.(2) About44%of the lesions shrank in size after treatment with Gamma knife radiosurgery (59/134).All the cavernous sinus cavernous angiomas shrank in size, higher than other patients(P<0.05).(3) During the follow-up period, the overall annual hemorrhage rate was1.6%(7/437). Patients with prior symptomatic hemorrhage showed higher annual hemorrhage rate (4.1%), compared with other patients (0.9%)(P<0.05).(4) The rate of radiation-induced cerebral edema was11.5%(14/122), which was improved markedly after treatment.Conclusion:(1) Gamma Knife treatment could improve the onset of the symptoms of epilepsy. However, when epilepsy responsibility lesions located in the temporal lobe, the improvement rate may be much lower.(2) Gamma knife radiosurgery was very suitable to treat cavernous sinus cavernous angiomas.(3) Whether Gamma Knife radiosurgery could reduce the risk of hemorrhage of intracranial cavernous angiomas was not clear. Patients with prior symptomatic hemorrhage showed a high risk of hemorrhage than other patients after Gamma Knife radiosurgery.