Imaging diagnosis and gamma knife treatment of cavernous sinus cavernous hemangiomas

Keywords: gamma knife, cavernous sinus, cavernous hemangioma, radiosurgery, outcome

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     Cavernous hemangiomas of the cavernous sinus pose treatment challenges.
To summarize the imaging characteristics of cavernous sinus cavernous hemangiomas (CSHAs) and evaluate the effects of Gamma Knife Radiosurgery(GKS) on CSHAs.
     16 patients were studied.
     The clinical data of 16 patients with CSHAs were analyzed retrospectively ,all cases were treated by GKS and with complete follow-up data in our hospital from September 2001 to December 2009. Of the 16 patients, 6 had residual tumor after surgery, 2 were biopsied ,and 8 were diagnosised by neuroradiology and follow-up data in recent years .The mean maximum diameter of tumors was 34.6mm (ranged 15.0-55.0mm ).,the mean tumor margin dose was 12.1Gy (ranged 8.0-15.0Gy) at the isodose line from 40% to 60%,the mean max dose was 24.3Gy(ranged 16.0-32.5Gy).The mean follow-up period was 40.5months (ranged 6-96months).
     No patients suffered from a new and eternal cranial nerve deficit after GKS treatment.2 patients suffered from transient oculomotor palsy among 3months and 6 months.Imaging findings revealed:of the 16 tumors ,4 almost disappeared ,10 decreased markly in size and 2 kept stable . 1 patient was treated again by GKS after 6 months ,and 2 patients were treated again for tumors decreased not remarkable in size, these tumors all decreased significantly in follow-up.
     This was a retrospective series.
     GKS treatment can be effective for control of growth with mild side-effects.  
     It is one of the best treatments for postoperative tumor residual, small and middle-size CSHAs, or for patients who are not suitable for craniotomy.


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