GAMMA KNIFE RADIOSURGERY FOR PITUITARY ADENOMA:

Case Summary:

This 49 years male from Quetta, underwent craniotomy & excision of seller SOL in March 30, 2022 presented with complaints of decrease right peripheral vision for 5 months & mild headache for few months. Patient has no history of radiation & chemotherapy. On clinical examination middle aged is sitting on the chair has right temporal field defect. MRI brain with contrast dated May 13, 2022 shows abnormal signal intensity enhancing mass lesion seen in cellar & supra cellar lesion suggestive of adenoma. Perimetry attached & shows field defect on right side. 

Follow up Comparataive Study After 6 months:

Patient visisted the GKSRS centre for the first routine follow up presented with improved clinical symptoms.

Recent MRI brain with contrast shows significant reduction in the targeted SOL , consistent with ongoing tumor control.

Follow up Comparative Study After 1 year:

Patient visisted gamma knife radiosurgery centre for second routine follow up , presented with almost resolved symtoms including good reversal of right temporal field defect.

recent MRI brain with contrast dated November 25,2024 shows further good reduction in targeted SOL only small residual disease seen, with no further growth, consistent with good ongoing response to GKSRS therapy.

 

Gamma Knife Radiosurgery for Craniopharyngioma

Case Summary:

22 years male from Quetta, presented with complaints of headache with nausea for 5 months and blurring of vision for few days. Patient has no history of surgery, radiation & chemotherapy. On clinical examination, patient has blurred vision.

 

Follow up Comparative Study after 6 months:

Patient visited the gamma knife center for the first routine follow up, presented with improved symptoms and good clinical health.

Recent MRI scans dated August 16,2023 shows siginificant reduction in the targeted SOL , consistent with ongoing good response to GKSRS therapy.

Follow up Comparative Study after 1 year:

Patient consulted the GKSRS Clinic with complete resolved symptoms and good health.

Recent MRI scans dated November 25,2024 shows almost complete resolution of targeted SOL with only small residual disease , no further growth , consistenet with good ongoing tumor control.

 

Gamma Knife Radiosurgery for Left Paraganglioma:

32 years female, underwent retro mastoid craniectomy in August 06, 2019 by Dr Farooq Azam presented with complaints of headache for 7 years, loss of left hearing before surgery, facial palsy after surgery & double vision for 1 year. Patient has no history of radiation & chemotherapy. On clinical examination patient has loss of left hearing left facial palsy & right 6^th nerve palsy. MRI brain with contrast dated August 12, 2022 shows large enhancing lesion seen in left side of base of skull at jugular fossa with intra cranial extension & left upper cervical extension & encasement of left internal carotid artery. Histopathology dated August 20, 2019 shows para ganglioma.

 Follow up Comparative Study :

Patient consulted the gamma knife center for the first routine follow up presented with recent MRI Brain with contrast dated October 2023 shows regression in the targeted lesion when compared with previous MRI Brain with contrast dated August 12, 2022 consistent with ongoing control of tumor.

 

Gamma Knife Radiosurgery For Left Parietal Glioma

Case Summary:

52 year lady, K/C of HTN presented with complaints of fits for 6 months & weakness in right limbs for 6 months. Patient has no history of surgery, radiation & chemotherapy. On clinical examination, patient is sitting on the chair has slightly affected working memory & right hemiparesis. MRI brain with contrast dated October 13, 2023 shows poorly enhancing intra axial abnormal signal intensity mass lesion seen in the left temporal parietal region involving the left basal ganglia.

PRE-OPERATIVE SCANS

 Follow up comparative study :

In comparison to the previous scans , there is regression in the targeted SOL with post radiation changes , consistet with ongoing response to GKSRS therapy.

 

Gamma Knife Radiosurgery for Brain Stem Glioma:

Case Summary:

This 27 year male from Multan, presented with complaints of facial asymmetry 8 months ago, weakness in left limbs for 4 months & difficulty in walking for 4 months & difficulty in swallowing for 2 weeks. Patient has no history of surgery, radiation & chemotherapy. On clinical examination young is sitting on chair comfortably & oriented has right facial palsy G-II & 4/5 power in left limbs. MRI brain with contrast dated August 20, 2022 shows diffuse non enhancing expansile mass lesion seen involving the brain stem, centered in the pons causing indentation of 4^th ventricle & involvement of the cerebellar peduncles. MRS choline peak with in the lesion suggestive of glioma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

 BEFORE TREATMENT

Follow-up Comparative Study 07-05-2024:

Patient consulted the gamma knife center for second routine follow up presented with recent MRI brain with contrast dated May 06,2024 shows good resolution of targeted lesion in T2 hyper intensity when compared with previous MRI brain with contrast dated April 04, 2023  consistent with ongoing control.

AFTER TREATMENT

 

 Gamma Knife Radiosurgery for Pituitary Adenoma.

Case Summary:

50 years male from Baluchistan, underwent trans sphenoidal excision of adenoma  in March 19, 2022 presented with complaints of progressive loss of right vision for 1 year & decrease left vision for 1 year. Patient has no history of chemotherapy and radiation therapy. On clinical examination pt. is blind from right eye with left temporal defect. MRI brain with contrast dated January 06, 2023 shows heterogeneous enhancing abnormal signal intensity mass lesion seen in sellar & supra sellar region suggestive of adenoma. Histopathology dated April 05, 2022 shows adenoma. Perimetry dated January 05, 2023 shows left temporal defect. Hormones profile within normal range. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study December 15, 2023:

Patient visited the gamma knife center for the first follow up presented with recent MRI brain with contrast dated December 14, 2023 shows further regression in the size of tumor from 4.6cc to 3.6 cc when compared with previous MRI brain with contrast dated July 04, 2023, consistent with good response to Gamma Knife Therapy

 

Gamma Knife Radiosurgery for Craniopharyngioma.

Case Summary:

9 years old boy from Karachi, underwent insertion of VP shunt in May 27, 2023 & revision of shunt in June 09, 2023  presented with history of headache with vomiting . Patient has no history of radiation & chemotherapy. On clinical examination patient has no obvious deficit. CT brain with contrast dated June 06, 2023 shows lobulated solid / cystic hypo dense mass seen in supra sellar / sellar region causing significant compression over 3^rd ventricle resulting dilatation of left lateral ventricle with CSF seepage suggestive of Craniopharyngioma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study March 28,2024:

Patient consulted the gamma knife center for the first routine follow up presented with recent MRI Brain with contrast dated december 06,2023 shows significant reduction in the targeted lesion from 20.20cc to 8.033cc when compared with previous MRI Brain with contrast datedJune 06, 2023  ,consistent with good ongoing control of lesion.

 Gamma Knife Radiosurgery for Right Occipital High Grade Glioma :

Case Summary:

40 years of male from Islamabad, underwent craniotomy for Excision of SOL in August 22, 2023 presented with the complaints of headache for 3 months & no history of visual disturbances. The patient has no history of radiation & chemotherapy. On clinical examination patient has no obvious deficit. MRI brain with contrast dated September 15, 2023 shows intra axial enhancing mass lesion seen in the right occipital region with post-surgical changes suggestive of residual high grade glioma. Histopathology dated September 01, 2023 shows malignant neoplasm (glioma). Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study 19-01-2024:

Patient consulted the gamma knife center for the second routine follow up presented with recent MRI brain with contrast dated January 15,2024 shows almost complete resolution of the targeted lesion with post radiation changes when compared with previous MRI brain with contrast dated September 15, 2023  consistent with excellent control of lesion.

 Gamma Knife Radiosurgery for CA Thyroid with Right Ventricle & Right Parietal Metastases.

Case Summary:

46 years of female from Dir, CA Thyroid underwent total thyroidectomy in June 23, 2023 presented with the complaints of headache with vomiting for few months, vertigo for 3 months & numbness in right limbs after surgery. Patient has no history of radiation & chemotherapy. On clinical examination patient has no obvious deficit. MRI brain with contrast dated August 12, 2023 shows recurrent lesion in left lobe of thyroid & metastasis lesions in right parietal lobe & right lateral ventricle suggestive of brain metastasis. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study January 13,2024:

Patient consulted the gamma knife center for the first follow up presented with recent MRI brain with contrast dated January 12,2024 shows good resolution of the targeted metastasis, no new growth seen when compared with previous MRI brain with contrast dated August 12, 2023,consistent with good ongoing control of tumor.

 

Gamma Knife Radiosurgery for Left Temporo-Parietal Glioma.

Case Summary:

23 years young male from Islamabad, presented with complaints of numbness in right limbs for 7-8 months & two episodes of LOC for 10-15 second for 8 months.  Patient has no history of surgery, chemotherapy & radiation. On clinical examination young man is sitting comfortably has no obvious deficit. MRI brain dated September 26, 2022 shows re-demonstrated mass lesion noted in left temporo-parietal region with surrounding white matter edema and mass effect evident by compression of the ipsilateral lateral ventricle. MR Spectroscopy dated July 25, 2022, shows neoplastic etiology likely low grade glioma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study April 11,2023:

Patient consulted the gamma knife center for the first routine follow up presented with recent MRI Brain with contrast dated April 04,2023 shows significant regression in T2 hypertensity (from 66.9 to 42.5cc) when compared with previous MRI Brain with contrast dated September 26,2022 consistent with excellent response to gamma knife therapy.

Follow up Comparative Study March 20,2024:

Patient consulted the gamma knife center for the second routine follow up presented with recent MRI Brain with contrast dated March 09,2024 shows further sizeable reduction in the targeted lesion when compared with previous MRI Brain with contrast dated April 04,2023  consistent with ongoing control of tumor.

 

Gamma Knife Radiosurgery for Left Temporo Parietal Low Grade Glioma:

Case Summary:

43 years lady from Haripur Hazara, presented with complaints of impairment of memory for few years & fits for 2 weeks. Patient has no history of surgery, radiation & chemotherapy. On clinical examination middle age lady  has slightly affected working memory. MRI brain with contrast dated November 23, 2022 shows non enhancing abnormal signal intensity mass lesion seen in left temporal lobe insular cortex, inferior frontal lobe & part of parietal lobe suggestive of low grade glioma. MRS shows elevated choline with reduced NAA & Cr peak suggestive of neoplastic lesion. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study July 11,2023:

Patient visited the gamma knife center for the first follow up presented with recent MRI brain with contrast dated June 19,2023 shows interval decrease of the targeted lesion in T2 hyper intensity signal when compared with previous MRI brain with contrast dated November 23,2022 , consistent with good ongoing control of tumor.

 Gamma Knife Radiosurgery for Nasal Angio Fibroma with Intra cranial Extension:

Case Summary:

14 years boy from Sanghar, underwent excision biopsy of tumor in March 26, 2022 by Dr. Imran presented with complaints of nasal blockage & nasal discharge for 1 year. The patient has no history of radiation & chemotherapy. On clinical examination boy is sitting on a chair comfortably has no obvious deficit. MRI brain & Para nasal sinuses dated January 10, 2022 shows a large infiltrating abnormally enhancing soft tissue intensity tumor is appreciated predominantly arising from the right lateral wall of naso pharynx close to the sphenopalantine fossa with extra axial intracranial extension. Histopathology dated April 08, 2022 shows nasal angiofibroma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up comparative study dated June 14,2023 :

Patient visited the gamma knife center for the first routine follow up presented with recent MRI brain with contrast dated June 14, 2023 shows 50% regression in the targeted lesion when compared with previous MRI brain with contrast dated January 10, 2022 consistent with good ongoing control of lesion.

Follow up comparative study dated January 12,2024 :

Patient visited the gamma knife center for the second routine follow up presented with recent MRI brain with contrast dated January 11, 2024 shows further regression in the targeted lesion when compared with previous MRI brain with contrast dated June 14, 2023  consistent with good ongoing control of lesion.

 

Gamma Knife Radiosurgery for Left Parietal Glioma.

Case Summary:

52 years male from Karachi, K/C of D.M presented with complaint of single episodes of loss of consciousness 10 days back. The patient has no history of surgery, chemo radiation. On clinical examination middle age man is sitting on a chair comfortably has slightly affected working memory. MRI brain with contrast dated September 29, 2022 shows extra axial enhancing mass lesion seen in the left parietal region & no enhancement on post contrast study suggests of low grade glioma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study 11-05-2023:

Patient visited the gamma knife center for first routine follow up presented with recent MRI brain with contrast dated May 10, 2023 shows significant regression in hyper intensity on T2WI with central necrotic changes seen when compared with previous MRI brain with contrast dated October 10, 2022 consistent with ongoing control of tumor.

 

 

Gamma Knife Radiosurgery for Pineal Region SOL.:

Case Summary:

22 years male, underwent insertion of VP shunt in November 11,2022 presented with complaints of headache, weakness in left limbs and blurring of vision for 3-4 months. Patient has no history of radiation & chemotherapy. On clinical examination young male is sitting on chair comfortably has squint and 4/5 power in left limbs. MRI brain with contrast dated November 05, 2022 shows enhancing mass seen in the midline causing compression of the aqueduct of sylvius with dilation of ventricles bilaterally. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study 06-04-2023:

Patient consulted the gamma knife center for the first routine follow up presented with recent MRI brain with contrast dated April 04,2023 shows good resolution of targeted lesion when compared with previous MRI brain with contrast dated November 05, 2022, excellent results in response to gamma knife therapy.

Follow up Comparative Study 25-01-2024:

Patient consulted the gamma knife center for the second routine follow up presented with recent MRI brain with contrast dated January  25,2024 shows almost complete resolution of the targeted lesion when compared with previous MRI brain with contrast dated April 04,2023, excellent results in response to gamma knife therapy.