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.