Gamma Knife Radiosurgery for Recurrent Posterior Fossa Hemangioblastoma

This 47 year old lady, diagnosed case of hemangioblastoma since 2014,underwent excision of posterior fossa SOL & insertion of VP shunt  in 2014 & received cyber knife treatment 7 Gy x 3 fraction in MAY 2015. Now presented with complaints of headache with vomiting & vertigo for 5 months & difficulty in walking for one month.  On clinical examination middle aged lady  has decreased vision & ataxia. MRI brain with contrast dated March 09, 2022 shows abnormal signal intensity enhancing mass lesion  in posterior fossa, involving the cerebellar vermis & shows  progression in disease when compared with previous MRI brain with contrast. Histopathology dated December 16, 2014 shows hemangioblastoma. Risk of GKSRS have been explained. Written and valid consent obtained to proceed. 

                                         PRE-GKSRS                                   POST-GKSRS

Follow-up Comparative Study after One year (February 07, 2023):

Patient visited the gamma knife center for second follow up presented with recent MRI brain with contrast dated  February 07, 2023  shows significant regression in the targeted hemangioblastoma from 27.9cc to 2.8 cc when compared with previous MRI brain with contrast dated March 09, 2022 consistent with good lesion control.

 

Gamma Knife Radiosurgery for Right Temporo Parietal GBM

Case Summary:

51 years old lady , K/C of HTN underwent excision of SOL in March 27, 2023, presented with complaints of weakness in left limbs for 2 months & fits since March 2023. Patient has no history of radiation & chemotherapy. On clinical examination patient has left hemiparesis (1/5 power). MRI brain with contrast dated March 27, 2023 shows enhancing abnormal signal intensity mass lesion seen at right temporo-parietal region suggestive of high grade glioma. Histopathology dated April 05, 2023 shows Glioblastoma G-IV. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study July 12,2023:

Patient visited the gamma knife center for the first follow up presented with recent MRI brain with contrast dated July 06,2023 shows almost 50% reduction in the targeted lesion when compared with previous MRI brain with contrast dated March 27,2023 , consistent with good ongoing control of tumor.

Procedure of Frame Placement in Gamma Knife Treatment.

Procedure of Gamma knife treatment with frame…..described by one of our patient.we grateful for her assistance. She was a great motivation for us to do even better service.

Gamma Knife Radiosurgery for Large Residual Craniopharyngioma.

 This 8 years child  underwent excision of supra sellar SOL & insertion of VP shunt  in April 24, 2022 presented with complaints of headache with vomiting before surgery & decrease left vision for 1 month.  CT scan brain plain dated April 19, 2022 shows a large hyper dense lesion seen in supra sellar region with multiple peripheral calcific foci causing compression effect over optic chiasm with hydrocephalus suggestive of craniopharyngioma.

Follow-up Comparative Study after 6months :

Patient visited the gamma knife center for first routine follow up presented with improvement of left vision.

Follow up MRI brain with contrast dated December 29, 2022 shows significant regression in tumor volume from 41 cc to 5.7 cc.

                                        

Follow-up Comparative Study after 1 year: 

Patient visited the gamma knife center for first routine Follow up presented with good health and no symptoms.Follow up MRI brain with contrast dated July 06, 2023 shows significant regression in tumor volume as reported previously.

       

Gamma Knife Radiosurgery For Recurrent Nasal Angiofibroma With Intracranial Extension.

 Case Summary:

This 17 year young male , underwent craniotomy in March, 2022 , presented with complaints of blindness from right eye for 4 years & bleeding from right side of the nose for 1 week. Patient has no history of radiation & chemotherapy. MRI brain with contrast dated May 27, 2022 shows interval progression of previously noted disease process when compare with previous scan. Risks of GKSRS have been explained. Written and valid consent obtained to proceed. They were agreed upon and they wish to proceed.

Follow up Comparative Study March 03,2023:

Recent MRI Brain with contrast dated March 27,2023 shows significant regression in the size of targeted lesion when compared with previous MRI Brain with contrast dated May 27,2022, consistent with good ongoing control of tumor.

                                             One Year Later.

Gamma knife Radiosurgery for Cystic Craniopharyngioma.

 

This 21 year male, underwent excision of supra sellar SOL in October 07, 2021  presented with complaints of decrease peripheral vision since July 2021 & headache before surgery. Patient has no previous history of radiation & chemotherapy. On clinical examination young boy is sitting on chair comfortably has field defect on both sides. MRI brain with contrast dated January 13, 2022 shows abnormal signal intensity mass lesion seen in supra sellar region suggestive of craniopharyngioma. Histopathology dated October 10, 2021 shows craniopharyngioma. Pituitary hormones dated October 25, 2021 shows decrease cortisol level (0.09). February 08, 2022 shows elevated IGF-1 level (507.40). Risks of GKSRS have been explained. Written and valid consent obtained to proceed. They were agreed upon and they wish to proceed.

Follow-up Comparative Study after 6 months:

Patient consulted the gamma knife center for first routine follow up presented with recent MRI brain with contrast dated September 08, 2022 shows almost complete resolution of previously targeted craniopharyngioma only tiny enhancing residual seen when compared with previous MRI brain with contrast dated February 15, 2022 suggestive of good response to therapy.

 

 

Gamma knife Radiosurgery For Pilocytic Astrocytoma WHO Grade-I

Case Summary:

This 06 year child  underwent endoscopic biopsy of SOL & insertion of VP shunt  in April 30,2022 , presented with history of headache & squint before surgery. The patient has no history of radiation & chemotherapy. On clinical examination patient has bilateral decreased vision. MRI brain with contrast dated May 26, 2022 shows abnormal signal intensity mass lesion seen in sellar & supra sellar region with hydrocephalus suggestive of neoplastic lesion. Histopathology dated May 11, 2022 shows pilocytic astrocytoma WHO-G-1. Risk of GKSRS have been explained. Written and valid consent obtained to proceed. They were agreed upon and they wish to proceed.

Follow up Comparative Study May 24,2023 shows almost complete resolution.

Gamma Knife Radiosurgery for Hypothalamic Glioma.

Case Summary: This 17 years female, underwent ETV and insertion of VP shunt in May 31,2022, presented with the complaints of headache with vomiting and blurring of vision for two months, symptoms improved after surgery. Patient has no previous history of radiation and chemotherapy. On clinical examination patient is oriented with time, place and person has no obvious deficits.MRI Brain with contrast April 16,2022 shows a complex supra Sellar mass reaching up to the foramen of Monro and causing asymmetrical dilation of lateral ventricle, suggestive of hypothalamic glioma.

Follow up images after 6 months showing significant regression in lesion size..