title: Stereotactic radiosurgery in hemangioblastoma: Experience over 14 years.
abstract: BACKGROUND
  Although gamma knife has been advocated for hemangioblastomas, it is not used widely by neurosurgeons.
  
  
  OBJECTIVE
  We review our experience over 14 years in an attempt to define the role of stereotactic radiosurgery (SRS) in the management of hemangioblastomas.
  
  
  METHODS
  A retrospective study was conducted on all patients of hemangioblastoma who underwent SRS at our institute over a period of 14 years (1998-2011). Gamma knife plans, clinical history, and radiology were reviewed for all patients.
  
  
  RESULTS
  A total of 2767 patients underwent gamma knife during the study period. Of these, 10 (0.36%) patients were treated for 24 hemangioblastomas. Eight patients (80%) had von Hippel-Lindau disease while two had sporadic hemangioblastomas. The median peripheral dose (50% isodose) delivered to the tumors was 29.9 Gy. Clinical and radiological follow-up data were available for eight patients. Of these, two were re-operated for persisting cerebellar symptoms. The remaining six patients were recurrence-free at a mean follow-up of 48 months (range 19-108 months). One patient had an increase in cyst volume along with a decrease in the size of the mural nodule.
  
  
  CONCLUSIONS
  SRS should be the first option for asymptomatic hemangioblastomas. Despite the obvious advantages, gamma knife is not widely used as an option for hemangioblastomas.
authors.affiliation: Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Nishant
authors.initials: N
authors.lastname: Goyal
authors.affiliation: Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Agrawal
authors.affiliation: Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Raghav
authors.initials: R
authors.lastname: Singla
authors.affiliation: Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shashank Sharad
authors.initials: SS
authors.lastname: Kale
authors.affiliation: Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Manmohan
authors.initials: M
authors.lastname: Singh
authors.affiliation: Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhawani Shankar
authors.initials: BS
authors.lastname: Sharma
keywords: Gamma knife radiosurgery; hemangioblastomas; stereotactic radiosurgery; von Hippel-Lindau syndrome