Introduction: Stereotactic radiosurgery (SRS) is increasingly used as a minimally invasive alternative in many neurosurgical conditions, including benign and malignant tumors, vascular malformations, and functional procedures. As for any surgical procedure, strict safety guidelines and checklists are necessary to avoid errors and the inherent unnecessary complications. With regard to the former, other groups have already reported human and/or technical errors. We describe our safety checklist for Gamma Knife radiosurgical procedures.
Methods: We describe our checklist protocol after an experience gained over 1500 radiosurgical procedures, using Gamma Knife radiosurgery, performed over a period of 8 years, while employing the same list of items. Minor implementation has been performed over time to address some safety issues that could be improved.
Results: Two types of checklist are displayed. One is related to the indications when a specific tissue volume is irradiated, including tumors or vascular disorders. The second corresponds to functional disorders, such as when the dose is prescribed to one specific point. Using these checklists, no human error had been reported during the past 8 years of practice in our institution.
Conclusion: The use of a safety checklist for SRS procedures promotes a zero-tolerance attitude for errors. This can lower the complications and is of major help in promoting multidisciplinary cooperation. We highly recommend the use of such tool, especially in the context of the increased use of SRS in the neurosurgical field.
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http://dx.doi.org/10.1007/s00701-019-03843-2 | DOI Listing |
J Neurooncol
January 2025
University of Virginia, Charlottesville, VA, USA.
Background: Even a gross total resection of a benign epidermoid tumor (ET) carries a high risk of recurrence. The management strategy mostly involves redo surgical excision but at a significant cost of morbidity and mortality. The role of adjuvant radiation therapies in this scenario is still undefined.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Background: Tremor, either in patients with Essential Tremor (ET) or Parkinson's disease (PD), constitutes the most common movement disorder. Stereotactic radiosurgery using Gamma Knife (GK) and linear accelerator (LINAC) systems, is an effective, incisionless treatment modality for ET and PD. Although these technologies have been used clinically since the 1990's, most studies have focused on GK, and efficacy, safety and time to treatment effect (latency) of GK and LINAC have not been compared.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
February 2025
Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester , Minnesota , USA.
Background And Objectives: The coexistence of complete carotico-clinoid bridge (CCB), an ossification between the anterior (ACP) and the middle clinoid (MCP), and an interclinoidal osseous bridge (ICB), between the ACP and the posterior clinoid (PCP), represents an uncommonly reported anatomic variant. If not adequately recognized, osseous bridges may complicate open or endoscopic surgery, along with the pneumatization of the ACP, especially when performing anterior or middle clinoidectomies.
Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, a systematic scoping review was conducted up to June 5, 2023.
Phys Med
January 2025
IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy.
Purpose: Total marrow (lymph-node) irradiation (TMI/TMLI) is a radiotherapy technique irradiating the whole body of a patient. The limited couch travel range in modern linacs (130-150 cm) forces to split the TMI/TMLI delivery into two plans with opposite orientation. A dedicated field junction is necessary to achieve satisfactory target coverage in the overlapping region of the two plans.
View Article and Find Full Text PDFEcancermedicalscience
November 2024
Cyberknife and Tomotherapy Center, Jinnah Postgraduate Medical Center (JPMC), Karachi 75510, Pakistan.
Introduction: The role of stereotactic radiosurgery (SRS) in pituitary adenomas (PAs) is evolving especially considering its safety. Existing literature is hampered by limited sample sizes and short-term follow-ups, impeding its preeminence in the clinical and radiological outcomes. We propose a comprehensive, single-centred study to evaluate the outcomes following CyberKnife stereotactic radiosurgery (CK SRS) for PAs in a larger patient population, incorporating meticulous clinical and radiological follow-up.
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