Gamma Knife Radiosurgery in Children

Abstract

52 pediatric patients were treated with radiosurgery at the University of California, San Francisco. Arteriovenous malformations were treated in 27 patients. Complete obliteration was noted in 4 of 12 patients imaged more than 2 years after radiosurgery. Arteriovenous malformation rebleed was noted in 1 patient. Symptomatic T2 changes were noted in 2 patients. Among 29 neoplasms treated in 25 patients, local control was noted in 5 of 7 low-grade gliomas, 5 of 14 high-grade gliomas, 4 of 5 craniopharyngiomas and 3 of 3 sarcomas. Three patients treated for neoplasms developed necrosis after radiosurgery.

Gamma‐knife radiosurgery in pediatric cerebral and skull base tumors

“…These ten tumors did, however, differ in respect to histology, since the group consisted of four low-grade glial tumors, one ependymoma, two craniopharyngeomas, one pineoblastoma, one rhabdomyosarcoma, and one atypical teratoid/rhabdoid tumor. This is in accordance with other reports [12,24,25]. The responders received a mean tumor margin dose of 13.8 Gy (range 10-18 Gy), while the two tumors that responded poorly received a mean dose of 13.6 Gy (range 10-25 Gy).…”

“…In the group of survivors, two patients with pilocytic astrocytoma (#4 and 5) and the two patients with craniopharyngeoma (#9 and 10) were given 10 Gy to a short segment of the visual pathways without developing visual disturbances. Baumann et al [24] found no long-term visual symptoms in two patients receiving >8 Gy to the chiasm. Only one out of 16 patients receiving a maximum of 16 Gy to the brainstem developed temporary symptoms of brainstem oedema.…”

Stereotactic radiosurgery for pediatric intracranial arteriovenous malformations: the University of California at San Francisco experience

“…Of the 27 patients for whom posttreatment MR imaging information was available for analysis, 10 patients had MR imaging documentation of T 2 changes after treatment, although only two were symptomatic, requiring several months of outpatient steroid treatment. These patients had received prescribed doses of 17.5 and 18.5 Gy, respectively, to AVMs measuring 6.1 and 2.5 cm 3 . A Fisher exact test did not demonstrate a correlation between the prescribed dose and the development of symptomatic edema (p Ͼ 0.5).…”

Hypothalamic Hamartoma Associated With Anterior Paraclinoid Aneurysm of the Internal Carotid Artery-Case Report-

“…Radiosurgery is technically well developed and acute side effects are rarely seen, but brain irradiation may give rise to side effects, particularly in children, so the option of radiosurgery has to be examined carefully. 5,7,17,20) Transient increase of seizure frequency may occur after radiosurgery. A 25-year-old man with a 24-year history of intractable gelastic and tonic-clonic seizures underwent GKS, and the frequency of the seizures transiently increased at 2 months, and then subsided at 3 months after the treatment.…”