Clinical results of Gamma Knife surgery for cavernous sinus hemangiomas

Abstract

The purpose of this study was to gain an understanding of the efficacy and safety of Gamma Knife surgery (GKS) for the treatment of cavernous sinus hemangiomas (CSHs). The authors report on 16 patients who underwent GKS as a primary or adjuvant treatment for CSH. Sixteen patients harboring CSHs (14 women and 2 men ranging in age from 21 to 65 years [mean 41.3 years]) underwent GKS at West China Hospital. In 4 patients the diagnosis was based on histological findings; in the other 12 patients it was based on findings on MR images. After patients were given a local anesthetic agent, the treatments were performed using a Leksell Gamma Knife model C. Gadolinium-enhanced MR images of T1-weighted, T2-weighted, and FLAIR sequences were obtained to determine the pretreatment location of the lesion. A mean peripheral dose of 13.3 Gy (range 11-14 Gy) was directed to the 40%-50% isodose line. The mean follow-up time in this study was 21.5 months (range 12-36 months). In 11 of 12 patients with symptoms, clinical improvement was reported at an average of 3.3 months (range 1-8 months) after GKS. Significant or partial tumor shrinkage was observed in 14 patients (87.5%) at the last follow-up. No new neurological impairments were reported after GKS. Magnetic resonance imaging may play an important role in the preoperative diagnosis of CSHs. Gamma Knife surgery may be a safe and effective primary or adjuvant treatment option for CSHs; however, long-term follow-up with more cases is needed to verify the benefits of this treatment.