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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Gamma Knife Radiosurgery for Arteriovenous Malformations: Clinical Series of 199 Patients(TURKISH NEUROSURGICAL SOC, 2017-01-01) Arslan, Ipek; Tezcanli, Evrim; Yilmaz, Meltem; Cizmeli, Olcay; Sengoz, Meric; Peker, SelcukAIM: Cerebral arteriovenous malformations (AVM) are pathological connections between arteries and veins without capillaries. Stereotactic radiosurgery (RS) is a proven and accepted treatment method for cerebral AVMs. Our objective was to analyze the factors influencing the clinical outcome in patients suffering from AVMs. MATERIAL and METHODS: We retrospectively reviewed 199 patients who were treated with Gamma-Knife RS for intracranial AVMs between 13 October 2005 and 31 October 2010. There were 89 male, 110 female patients with a median age of 32 years (range, 3-74 years). Obliteration was assessed with MRI angiography and DSA imaging. RESULTS: Complete obliteration rate after RS was 71 \% (141 out of 199), including second RS treatments. In terms of obliteration rates, there was no significant difference between patients younger and older than 21 years old (p=0.669). After RS, 3 patients died due to intracranial hemorrhage and 1 died of heart disease. Death from AVM was determined as 1.5 \%. Intracranial hemorrhage was observed in 7 (3.5 \%) patients post-RS. CONCLUSION: Obliteration was found to be associated with Spetzler-Martin Grade, Pollock-Flickinger Grade, AVM volume, RS dose, bleeding history before RS and no previous embolization before RS. Gamma knife RS is an effective treatment method for the treatment of AVMs both for pediatric and adult patients. It provides high obliteration and low mortality rates.Item Gamma Knife Radiosurgery for Anterior Clinoid Process Meningiomas: A Series of 61 Consecutive Patients(ELSEVIER SCIENCE INC, 2020-01-01) Akyoldas, Goktug; Hergunsel, Omer Batu; Yilmaz, Meltem; Sengoz, Meric; Peker, SelcukOBJECTIVE: Gamma Knife radiosurgery (GKRS) outcomes for anterior clinoid process (ACP) meningiomas have not been specifically reported within any meningioma series. We present the initial and largest series in the literature that describes the presenting features, radiosurgery parameters, and radiologic and long-term clinical outcomes for 61 patients with ACP meningiomas treated with GKRS. METHODS: Medical records were reviewed for 61 consecutive patients at a single center who underwent GKRS for ACP meningioma between 2008 and 2016. RESULTS: Of 61 patients with ACP meningiomas, 49 (80\%) were treated with GKRS as primary treatment, and 12 (20\%) were treated with GKRS as an adjuvant therapy. Before GKRS, 29 patients presented with visual impairment and 50 patients presented with headache. Median patient age was 54.9 years. Median tumor volume was 3.2 cm(3), and median margin dose was 12.0 Gy. The median radiologic follow-up time after GKRS was 75 months. During follow-up, tumor volume regressed in 37 cases (61\%) and remained unchanged in 24 cases (39\%). None of the patients experienced tumor volume progression. Tumor volume <3 cm(3) was an independent predictor of tumor volume regression after GKRS (univariate analysis, P = 0.047