Gamma Knife Surgery for the Treatment of Spontaneous Dural Carotid-Cavernous Fistulas
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概要
- 論文の詳細を見る
Endovascular treatment for a spontaneous dural carotid-cavernous fistula (CCF) is an established treatment, but stereotactic radiosurgery might provide a less-invasive alternative in selected cases. Four women aged 67 to 79 years (mean 72.0 years) with spontaneous dural CCFs presented with chemosis orbruit. Angiography revealed arteriovenous fistulas in the cavernous portion. Three cases were Barrow type D and one was type B converted from type D. Stereotactic gamma knife surgery was performed with a marginal dose of 13-15 Gy and a maximum dose of 26-30 Gy with a volume from 824 to 1755 mm^3. The target point of radiosurgery for type D CCFs was the compartment of the cavernous sinus supplied by multiple feeders from the external carotid artery. All patients responded favorably to the treatment, with improvement of symptoms beginning after 1 to 3 months. Angiography confirmed the complete disappearance of the CCFs in all patients. There were no recurrences, and the follow-up period was 14 to 32 months (mean 24 months). No significant side effects were observed. Stereotactic radiosurgery is a useful method to treat CCFs and is indicated for elderly patients, low-flow CCFs, and cases in which endovascular treatment has failed.
- 日本脳神経外科学会の論文
- 2003-10-15
著者
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ONIZUKA Masanari
Department of Neurosurgery, Fukuoka University Chikushi Hospital
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Hiu Takeshi
Department Of Neurosurgery National Nagasaki Medical Center
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Hiu Takeshi
Department Of Neurosurgery Nagasaki University Graduate School Of Biomedical Sciences
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TODA Keisuke
Department of Neurosurgery Institute of Neurosciences, St. Mary's Hospital
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Toda Keisuke
Department Of Neurosurgery Institute Of Neurosciences St. Mary's Hospital
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Toda Keisuke
Department Of Neurosurgery National Nagasaki Medical Center
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BABA Hiroshi
Department of Anesthesiology, Faculty of Medicine, Niigata University
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MORI Katsuharu
Department of Neurosurgery, Nagasaki University School of Medicene
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TAKAHASHI Nobuaki
Department of Applied Physics, National Defense Academy
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YONEKURA Masahiro
Department of Neurosurgery, National Nagasaki Medical Center
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KAWAHARA Ichiro
Department of Neurosurgery, National Nagasaki Medical Center
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Kawahara Ichiro
Department Of Neurosurgery Nagasaki Prefectural Shimabara Hospital
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Onizuka Masanari
Department Of Neurosurgery Fukuoka University Chikushi Hospital
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Onizuka Masanari
Department Of Neurosurgery National Nagasaki Medical Center:(present Address)center For Neuroendovas
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Mori Katsuharu
Department Of Neurosurgery Miyazaki Hospital
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Yonekura Masahiro
Department Of Neurosurgery Nagasaki Medical Center
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Yonekura Masahiro
Department Of Neurosurgery National Nagasaki Medical Center
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Kawahara Ichiro
Department Of Neurosurgery National Nagasaki Medical Center
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Baba Hiroshi
Department Of Neurosurgery National Nagasaki Medical Center
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Baba Hiroshi
Department Of Anesthesiology Faculty Of Medicine Niigata University
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Takahashi Nobuaki
Department Of Applied Physics National Defense Academy
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Takahashi Nobuaki
Department Of Neurosurgery Fukuoka Memorial Hospital
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Kawahara Ichiro
Department of Industrial Chemistry, School of Engineering, Okayama University
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