Stereotactic Radiosurgery for Benign Cavernous Sinus Meningiomas: A Multicentre Study and Review of the Literature.

Cavernous sinus meningiomas (CSMs) remain a surgical challenge due to the intimate involvement of their contained nerves and blood vessels. Stereotactic radiosurgery (SRS) is a safe and effective minimally invasive alternative for the treatment of small- to medium-sized CSMs. Objective: To assess the medium- to long-term outcomes of SRS for CSMs with respect to tumour growth, prevention of further neurological deterioration and improvement of existing neurological deficits.

European consensus conference on unruptured brain AVMs treatment (Supported by EANS, ESMINT, EGKS, and SINCH).

In December of 2016, a Consensus Conference on unruptured AVM treatment, involving 24 members of the three European societies dealing with the treatment of cerebral AVMs (EANS, ESMINT, and EGKS) was held in Milan, Italy. The panel made the following statements and general recommendations: (1) Brain arteriovenous malformation (AVM) is a complex disease associated with potentially severe natural history; (2) The results of a randomized trial (ARUBA) cannot be applied equally for all unruptured brain arteriovenous malformation (uBAVM) and for all treatment modalities; (3) Considering the multiple treatment modalities available, patients with uBAVMs should be evaluated by an interdisciplinary neurovascular team consisting of neurosurgeons, neurointerventionalists, radiosurgeons, and neurologists experienced in the diagnosis and treatment of brain AVM; (4) Balancing the risk of hemorrhage and the associated restrictions of everyday activities related to untreated unruptured AVMs against the risk of treatment, there are sufficient indications to treat unruptured AVMs grade 1 and 2 (Spetzler-Martin); (5) There may be indications for treating patients with higher grades, based on a case-to-case consensus decision of the experienced team; (6) If treatment is indicated, the primary strategy should be defined by the multidisciplinary team prior to the beginning of the treatment and should aim at complete eradication of the uBAVM; (7) After having considered the pros and cons of a randomized trial vs. a registry, the panel proposed a prospective European Multidisciplinary Registry.

Thyrotropin-secreting pituitary adenomas: outcome of pituitary surgery and irradiation.

Objective: Our objective was to describe the effects of surgery and radiotherapy on hormonal control and tumor mass in short- and long-term follow-up of TSH-secreting pituitary adenomas (TSHomas).

Methods: This was a retrospective multicenter study.

Results: We collected data of 70 TSHomas (70% macroadenomas).

Targeting and conformality in arteriovenous malformation radiosurgery.

The struggle to achieve a high degree of conformity around targets of complex morphology has been one of the driving forces in the development of ever more sophisticated radiosurgical devices and intricate treatment delivery. Rarely are radiosurgical targets more complex in shape than those associated with arteriovenous malformations (AVMs). In this report we examine theoretical and practical issues of target delineation and creation of conformal AVM treatment plans, and comment on the concepts of gradient and homogeneity.

Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients.

Background: Radiosurgery is the main alternative to microsurgical resection for benign meningiomas.

Objective: To assess the long-term efficacy and safety of radiosurgery for meningiomas with respect to tumor growth and prevention of associated neurological deterioration. Medium- to long-term outcomes have been widely reported, but no large multicenter series with long-term follow-up have been published.

Efficacy and tolerability of gamma knife radiosurgery in acromegaly: a 10-year follow-up study.

Objective: The long-term efficacy and safety of stereotactic radiosurgery by gamma knife (GK) still remain unknown. The aim of the study was to investigate the long-term efficacy and tolerability of GK in acromegalic patients.

Design And Patients: Retrospective analysis for a median follow-up of 10 years.

Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study.

Stereotactic radiosurgery by gamma-knife (GK) is an attractive therapeutic option after failure of microsurgical removal in patients with pituitary adenoma. In these tumors or remnants of them, it aims to obtain the arrest of cell proliferation and hormone hypersecretion using a single precise high dose of ionizing radiation, sparing surrounding structures. The long-term efficacy and toxicity of GK in acromegaly are only partially known.

Hearing loss and changes in transient evoked otoacoustic emissions after gamma knife radiosurgery for acoustic neurinomas.

Objective: To evaluate the neuro-otological effects of gamma knife radiosurgery in patients with acoustic neurinoma.

Design: Prospective study.

Setting: University hospital in Milan, Italy.