Therapeutic effect of gamma knife on intracranial cavernous angioma / 中南大学学报(医学版)

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

Efficacy and prognosis of trigeminal neuralgia treated with surgical excision or gamma knife surgery / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the curative effects and complications when using microvascular decompression (MVD) or gamma knife surgery (GKS) to treat trigeminal neuralgia (TN). And to investigate the prognosis for TN after these treatments.@*METHODS@#Sixty-one TN patients treated using MVD and eighty-six TN patients treated using GKS were enrolled by means of telephone, letter or out-patient recheck; the patients had originally presented from December 1996 to June 2010. A chi-square test was applied to follow-up data on pain relief after 1 month, 6 months and 12 months, and at the final follow-up.@*RESULTS@#One hundred and two patients were followed for 3-151 months. Cumulative pain relief rates at 1, 6, 12 months and at end times were 90.48%, 95.24%, 92.86%, and 95.24%, respectively, for forty-two MVD-treated patients, and 23.33%, 83.33%, 86.67% and 90% for sixty GKS-treated patients, respectively. The effects of two methods for treatment of TN was not statistically different (χ(2) = 2.053, P=0.152). Pain relief rates in the short-term (first month) demonstrated statistically significant differences (P0.05).@*CONCLUSION@#Immediate pain relief with MVD treatment is higher than with GKS, but in the long term both treatments were comparable.

Comparison of prognosis of skull base chordoma treated by surgical resection and gamma knife surgery / 中南大学学报(医学版)

OBJECTIVE@#To analyze the complication, survival and life quality, and to explore the efficacy and prognosis of skull base chordoma treated by open surgery and gamma knife surgery (GKS).@*METHODS@#Thirty-eight patients with skull base chordomas who underwent an open surgery and another 19 patients who underwent GKS between January 2002 and January 2010 were followed up. The Karnofsky performance scale (KPS) at admission,discharge and follow-up, and recurrent rates were calculated through SPSS life-table, and survival rate curve was used to evaluate the efficacy and prognosis.@*RESULTS@#Forty patients were followed up, and the survival rate of 1, 3 and 5 years was 92.6%, 74.3% and 60% in 27 patients with open surgery, and 100%, 83.3% and 62.5% in 13 patients with GKS respectively. There was no significant difference between the 2 groups (χ(2)=0.867, P=0.353). There was no significant difference in the KPS score between the 2 groups (P=0.138).@*CONCLUSION@#Despite the poor prognosis of skull base chordoma, GKS can effectively improve the survival rate and present life quality of patients with skull base chordoma.

Diagnosis and treatment of cystic meningioma / 中南大学学报(医学版)

OBJECTIVE@#To explore the pathogenetic mechanism of cystic meningioma and the key to its diagnosis and operation.@*METHODS@#Clinical data of 8 patients with cystic meningioma were analyzed retrospectively. The occuring position and cure rate of cystic meningioma were compared with those of solid meningioma in the corresponding period.@*RESULTS@#All patients were subjected to total resection of tumor parenchyma and cystic wall. No operative death and severe complications occurred. The incidence of uppertentorial region of cystic meningioma was higher than that of solid meningioma, and the difference was significant (χ(2)=2.618, P0.05).@*CONCLUSION@#Removing tumor totally is the key to preventing its recurrence.

Clinical characteristics and operative effect of hippocampus lesions / 中南大学学报(医学版)

OBJECTIVE@#To study the clinical characteristics and operative effect of hippocampus lesions.@*METHODS@#We retrospectively analyzed the clinical characteristics and operative outcome of 44 patients with hippocampus lesions between August 2005 and April 2010.@*RESULTS@#Seizure attack was the initial symptom among 40 of the 44 patients. Pathological examinations revealed 18 gliomas, 9 cavernous malformations, 12 hippocampus sclerosis, 2 focal cortical dysplasia, 1 atypical hyperplasia, 1 injury glial scar, and 1 encephalomalacia. Thirteen patients received anterior medial temporal lobectomy and the other 31 received lesionectomy or selective amygdalohippocampectomy via transsylvian approach. An average of 15.7 month follow-up was accomplished in 37 patients. Postoperative epileptic outcomes were evaluated according to Engel classification: Grade I 73.0%(27/37), Grade II 13.5%(5/37), Grade III 10.8%(4/37) and Grade IV 2.7%(1/37). No perioperative death occurred. One patient experienced hemiplegia but recovered 8 months after the operation. Noticeable postoperative visual field deficit was left in 2 patients. Two patients with glioma died of remote tumor recurrence during follow-up.@*CONCLUSION@#Seizure attack is a major complaint of hippocampus lesions. Satisfactory seizure and tumor control may be achieved through anterior medial temporal lobectomy or selective amygdalohippocampectomy with lesionectomy.