Gamma knife in posterior third ventricular tumors

Vikas Naik, Deepak Agrawal, SS Kale, MS Sharma, BS Sharma, AK Mahapatra Department of Neurosurgery & Gamma-Knife surgery, All India Institute of Medical Sciences, New Delhi

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[object Object],[object Object],[object Object],12/18/2009 NSI-2009

[object Object],12/18/2009 NSI-2009

[object Object],[object Object],[object Object],[object Object],12/18/2009 NSI-2009

[object Object],[object Object],12/18/2009 NSI-2009

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12/18/2009 NSI-2009 Diagnosis Histology proven MRI based Csf diversion Adjuvant RT Adjuvant CT Meningiomas (8) 4 4 1 0 0 Pineal tumors (4) 3 1 3 1 1 Gliomas (3) 2 1 1 1 0 PNET (1) 1 0 1 0 1 Metastasis (1) 0 1 0 0 0 Total (17) 10 7 6 2 2

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12/18/2009 NSI-2009 Symptom No of patients in Primary GK No of patients in Secondary GK Percentage HEADACHE 4 4 47 ASYMPTOMATIC 4 1 29.4 VOMITING 1 2 17.6 HEMIPARESIS 1 2 17.6 DROOPING OF EYELID 1 1 11.76 SEIZURES 1 0 5.8 MEMORY IMPAIRMENT 1 0 5.8 GAIT ATAXIA 1 0 5.8 URINARY INCONTINIENCE 1 0 5.8 DIPLOPIA 1 0 5.8

12/18/2009 NSI-2009 SIGNS No of patients of Primary GK No of patients of secondary GK PERCENTAGE NO DEFICITS 5 3 47 HEMIPARESIS 1 3 23.5 PAPILLOEDEMA 2 1 17.6 PARINAUDS 1 1 11.76 SEVENTH NERVE 1 1 11.76 THIRD NERVE 1 1 11.76 RECENT MEMORY 1 0 5.8 NYSTAGMUS 0 1 5.8

[object Object],12/18/2009 NSI-2009 Diagnosis Follow up period (months) Tumor volume (cm3) Radiation iso dose (Gy) Tumor control Worsening Beningn Meningiomas 41 9.05 11.8 4/4 - Pinealocytomas 36 2.2 15 1/1 - Glioma 9 3.3 12 1/1 - Malignant Pinealoblastoma 15.5 2.05 20.75 1/2 1/2 Metastasis 7 44.3 16 - -

SECONDARY GK 12/18/2009 NSI-2009 Diagnosis Follow up period (months) Tumor volume (cm3) Radiation iso dose (Gy) Tumor control Worsening Beningn Meningiomas 54 12.5 12.52 4/4 - Gliomas 4 6.25 16 1/1 - Malignant Pinealoblastoma 9 1.4 24 1/1 - PNET 25 3.2 16 1/1 -

Pinealocytoma at GK Pinealocytoma post 24 months GK 12/18/2009 NSI-2009

Meningioma at GK Meningioma after 75 months GK 12/18/2009 NSI-2009

Pinealoblastoma Pre- Operative 12/18/2009 NSI-2009

At GK planning Pinealoblastoma 9 month after GK 12/18/2009 NSI-2009

Gamma knife in posterior third ventricular tumors

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Gamma knife in posterior third ventricular tumors