title: Neuroophthalmological evaluation after Gamma Knife surgery for cavernous sinus meningiomas.
abstract: OBJECTIVE
  Treatment options for patients with cavernous sinus meningiomas (CSMs) include microsurgical tumor resection, radiotherapy, and radiosurgery. Gamma Knife surgery (GKS) is increasingly being used because it is associated with lower mortality and morbidity rates than microsurgery. The purpose of this study was to assess the role of GKS in the treatment of CSM and to thoroughly analyze the clinical response to GKS.
  
  
  METHODS
  Between January 2001 and December 2005, 123 patients (25 men and 98 women; mean age 62.6 +/- 11 years, range 31-86 years) who underwent treatment for CSMs were included in this study. Of these, 41 patients underwent microsurgery before GKS, whereas the remaining 82 had GKS as a first-line therapy after a diagnosis was made based on magnetic resonance imaging findings. Dysfunction in cranial nerves (CNs) II, III, IV, V, and VI was noted in 74 patients at the time of GKS. The mean tumor volume was 7.99 cm(3) (0.7-30.5 cm(3)). The mean prescription dose to the tumor margin was 13.8 +/- 1.1 Gy (range 10-20 Gy).
  
  
  RESULTS
  The overall tumor control rate was 98.4% with a median follow-up of 36 months. The actuarial tumor control rate at 5 years was 90.5%. A reduction in tumor volume was observed in 53 patients (43.1%), whereas in 68 patients (55.3%) no volumetric variation was recorded. Of the 74 patients who presented with CN deficits, improvement was noted in 23 (31.1%).
  
  
  CONCLUSIONS
  Gamma Knife surgery is a useful treatment for CSM both as a first- or second-line therapy. It is a safe and effective treatment for tumors located close to the optic pathways.
authors: Gamma Knife Unit, Department of Neurosurgery, San Raffaele Scientific Institute, Milan, Italy. franzin.alberto@hsr.it
authors: Alberto
authors: A
authors: Franzin
authors: Alberto
authors: A
authors: Vimercati
authors: Marzia
authors: M
authors: Medone
authors: Carlo
authors: C
authors: Serra
authors: Stefania Bianchi
authors: SB
authors: Marzoli
authors: Maddalena
authors: M
authors: Forti
authors: Lorenzo
authors: L
authors: Gioia
authors: Micol
authors: M
authors: Valle
authors: Piero
authors: P
authors: Picozzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002426:Cavernous Sinus / Q000601:surgery*; D003391:Cranial Nerves / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008579:Meningioma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D012189:Retrospective Studies