Background: Cavernous angioma or cavernoma is a benign vascular malformation, which can be found at any region within the brain. Brain stem cavernous angioma is rare. Although the optimal management of intracranial cavernous angiomas is open resection, Gamma Knife radiosurgery (GKR) has played an important role in treating these deeply seated and high surgical risk malformations throughout the past 20 years. Aim of the study: Our study aimed to evaluate the efficacy, and safety of Gamma Knife radiosurgery in the management of brainstem cavernous angiomas.
Patients and Methods: Our retrospective study was conducted on 22 patients with brainstem cavernous hemangioma who underwent gamma knife at the Gamma Knife center (GKC), Nasser Institute Hospitals, Cairo in collaboration with department of neurosurgery, Ain Shams University. Follow up period 24-132 months, mean follow up period 51 months.
Results: In the present series we have satisfactory results as regards reducing rebleeding rate, we have post radiosurgery
rebleeding rate of 2.8%. It represents the sum of the bleeding rate for all patients in the study including those who have rebleeding rate 30% preradiosurgical. As regards control of improvement of presenting manifestations, we have also excellent results in the present series (75%) of patients showed improvement of the symptoms, (25%) remained stable clinically. Reduction of cavernoma size after treatment was observed also in our series for 77.3% of the lesions. There was no permanent morbidity post gamma knife, only 3 transient morbidities were happened due to edema and bleeding.
Conclusion: As the development of stereotaxic radiosurgery and more experience accumulated, GKR has become an effective and safe alternative method for brainstem cavernous angiomas treatment.