Neurological outcomes after gamma knife radiosurgery for symptomatic skull base meningiomas based on their locations: Single institution experience

Abstract

Background and objective: Gross total resection of skull base meningioma is so challenging due to its relevant high morbidity. Gamma knife radiosurgery is concerned by providing a favorable therapeutic option in the management of SBM. This study aims to evaluate the neurological outcome after GKRS as an adjuvant or primary treatment for SBM according to their locations. Methods: This retrospective cross-sectional study consisted of 108 patients with SBM who underwent GKRS as an adjuvant or primary treatment. We found 40 patients with cavernous sinus meningioma (CSM), 36 patients with petroclival meningioma (PCM), and 22 patients with cerebellopontine angle meningioma (CPM). 81.1% of whom were female (n = 90) with a median age of 52.68 years. The mean tumor volume was 4.5 cm3 and the mean marginal dose was 13 Gy. Results: Tumor control was achieved in 96.4 % of patients at a median follow-up of 38.4 months. Over all 17 of 108 patients (15.6%) report improvement in their neurological symptoms. Patients with CPM demonstrated lower rates of neurological symptoms improvement compared to patients with PCM and CSM. Deterioration of neurological symptoms after GKRS developed in 11 patients (10.1%) which was more reported by patients with CSM than the others. The most improvement in cranial nerve deficit was in CN Ⅵ, Ⅴ, VIII among patients with CSM, PCM, and CPM respectively. Conclusion: GKRS is acceptable as a primary or adjuvant treatment for SBM by providing an appreciable rate of improvement in neurological symptoms.

Keywords

• Gamma Knife Radiosurgery
• Skull base
• Meningiomas
• Cranial nerves