Gamma knife radiosurgery of meningiomas in the cavernous sinus region

For 6 years (1992-1998) we have treated 67 patients with cavernous sinus me ningioma using the Leksell gamma knife in the Hospital Na Homolce, Prague. The age of the patients ranged between 19-82 years, median 57 years. Radios urgery was the primary treatment in 64,2% of the patients, in the rest a mi crosurgical resection preceded. The volume of the tumour ranged from 0,9-31 ,4 cm(3), median 7,8 cm(3). The meningioma was distant from the optic tract in 58% of the cases, in 12% of the cases there was a contact with the tumo ur and the optic tract without its compression and in 30% of the cases ther e was a compression of the optic tract caused by the meningioma. The dose t o the tumour margin ranged from 10-14 Gy, median 12 Gy. The follow up was a vailable in 53 patients, in intervals of 2-60 months, median 19 months. The re was no change in the tumour volume in 48% of the cases, in 52% of the ca ses a decrease of the tumour volume occurred. No increase of the tumour vol ume was observed. Clinical symptoms and signs improved in 35,8% of the pati ents, temporary morbidity was 3,8%. The mortality of the treatment was zero . Hitherto, the results of gamma knife radiosurgery of cavernous sinus mening ioma have proved its safety and efficiency, although long term experience w ith a large group of patients is missing. Advances in neuroradiology and ra diosurgical technique have allowed us to treat tumours with a closer contac t to the optic tract and nerves compared with the past.