Gamma Knife Stereotactic Radiosurgery (GKS) for the treatment of meningiomas – a study of 550 cases

. Meningiomas are benign tumors which originate from the cells of the arachnoid granules. Meningiomas represent a special pathologic entity for neurosurgeons due to the fact that they can grow silently for a long time, and can affect important neural structures when they become symptomatic. The total resection of meningiomas is curative. For the meningiomas which are not surgically accessible and for reoccurrence. Gamma Knife radiosurgery (GKS) is a very efficient solution. Materials and methods. The study below presents the experience of the authors regarding the use of GKS for the treatment of meningiomas. The authors focus on a population of 550 patients diagnosed and treated for meningiomas over a period of 10 years at the „Bagdasar-Arseni“ University Hospital in Bucharest. This study compares the impact of GKS when performed alone or in association with open microneurosurgery. The authors assessed patients with tumors ranging between 1 and 42 cm3 in volume. GKS is used successfully to treat meningiomas, both independently and in association with open microsurgery. Results. The major complications of the treatment are represented by lack of response to treatment (7% of patients) and transient cerebral edema (22% of patients). A disturbing phenomenon happens in a few meningiomas of the convexity, with malignant edema (<1%). Conclusion. Given the multiple advantages it has, GKS is right now the tip of the spear regarding the therapeutical methods available for meningiomas. These tumors usually are benign in nature; however, a small percentage are malignant. Often, meningiomas cause no symptoms and require no immediate treatment. But the growth of benign meningiomas can cause serious problems. In some cases, such growth can be fatal. Typically, symptomatic meningiomas are treated with either radiosurgery or conventional surgery. When the tumors met in daily practice are larger than the therapeutical resources of the devices used for GKS, an open microsurgical approach may be attempted followed by stereotactic irradiation of the remnant tumor.