Abstract:
OBJECT:Despite the controversy over the clinical significance of Gamma Knife surgery (GKS) for refractory mesial temporal lobe epilepsy (MTLE), the modality has attracted attention because it is less invasive than resection. The authors report long-term outcomes for 7 patients, focusing in particular on the long-term complications. METHODS:Between 1996 and 1999, 7 patients with MTLE underwent GKS. The 50% marginal dose covering the medial temporal structures was 18 Gy in 2 patients and 25 Gy in the remaining 5 patients. RESULTS:High-dose treatment abolished the seizures in 2 patients and significantly reduced them in 2 others. One patient in this group was lost to follow-up. However, 2 patients presented with symptomatic radiation necrosis (SRN) necessitating resection after 5 and 10 years. One patient who did not need necrotomy continued to show radiation necrosis on MRI after 10 years. One patient died of drowning while swimming in the sea 1 year after GKS, before seizures had disappeared completely. CONCLUSIONS:High-dose treatment resulted in sufficient seizure control but carried a significant risk of SRN after several years. Excessive target volume was considered as a reason for delayed necrosis. Drawbacks such as a delay in seizure control and the risk of SRN should be considered when the clinical significance of this treatment is evaluated.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Usami K,Kawai K,Koga T,Shin M,Kurita H,Suzuki I,Saito Ndoi
10.3171/2012.2.JNS111296subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1221-5issue
6eissn
0022-3085issn
1933-0693journal_volume
116pub_type
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journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.6.1098
更新日期:2004-06-01 00:00:00
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journal_title:Journal of neurosurgery
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doi:10.3171/2017.9.JNS172231
更新日期:2018-03-23 00:00:00
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pub_type: 杂志文章
doi:10.3171/jns.2000.93.2.0245
更新日期:2000-08-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/JNS/2008/109/10/0715
更新日期:2008-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
abstract::Coccidioidomycosis is an infection originating in the San Joaquim Valley of southern California, but now seen with increasing frequency throughout southern California and the southwestern United States. Central nervous system involvement is usually manifested as meningitis. The authors present the case of a young man ...
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pub_type: 杂志文章
doi:10.3171/jns.1994.80.1.0140
更新日期:1994-01-01 00:00:00
abstract::OBJECTIVE Electrical motor cortex stimulation can relieve neuropathic pain (NP), but its use requires patients to undergo an invasive procedure. Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) using a figure-8 coil can relieve NP noninvasively, but its ability to relieve lower limb...
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-11-01 00:00:00
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journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/9/0553
更新日期:2008-09-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/jns.1991.75.3.0447
更新日期:1991-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2004-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-07-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/2010.2.JNS091595
更新日期:2010-10-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.3171/spi.1999.91.2.0223
更新日期:1999-10-01 00:00:00
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doi:10.3171/jns.2003.99.1.0100
更新日期:2003-07-01 00:00:00
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更新日期:2014-09-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/2008.3.17433
更新日期:2009-02-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/JNS/2008/109/11/0817
更新日期:2008-11-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/2013.7.JNS1323
更新日期:2013-12-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/2015.6.JNS15622
更新日期:2016-07-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/jns.1986.65.5.0704
更新日期:1986-11-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/jns.2002.96.1.0097
更新日期:2002-01-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/jns.1998.88.2.0237
更新日期:1998-02-01 00:00:00
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journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.6.JNS11513
更新日期:2011-11-01 00:00:00
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journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1986.65.5.0579
更新日期:1986-11-01 00:00:00
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journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.3.0523
更新日期:2004-03-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/JNS-07/08/0352
更新日期:2007-08-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/jns.2005.102.s_supplement.0049
更新日期:2005-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-02-15 00:00:00
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journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.1.0037
更新日期:1992-07-01 00:00:00