Gamma Knife Applications in and around the Pituitary Fossa
The pituitary region was one of the first regions to be attacked therapeutically, with open stereotactic technique. This is because the soft tissues have a relatively fixed relationship to the base of the skull and could be outlined with adequate detail, using different forms of air study. In consequence, adequate localization of the pituitary region, for puncture of cysts located in that region, was available at an early date. Thus, Leksell’s very first patient in his first frame was treated with instillation of 32P into a craniopharyngioma cyst; as early as 1948. Moreover, Wycis had treated a cystic pituitary adenoma with intracavity 32P in 1954. However, the use of this isotope against pituitary adenomas never really caught on. It was Backlund who first began the systematic treatment of tumours of this region with stereotactic technique, using the intracavity instillation of Yttrium-90 to treat craniopharyngioma cysts. This treatment was to prove highly successful. Thus, it was natural that one of Backlund’s patients should be the first candidate for Gamma Knife surgery, as mentioned in chapter 6.
KeywordsPituitary Adenoma Cavernous Sinus Gamma Knife Stereotactic Radiosurgery Gamma Knife Surgery
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Suggested Further Reading
- 1.Backlund E-O (1979) Stereotactic radiosurgery in intracranial tumours and vascular malformations. In: Krayenbühl H, et al (eds) Advances and technical standards in neurosurgery, vol 6. Springer, Wien New York, pp 1–37Google Scholar
- 2.Backlund E-O, Axelsson B, Bergstrand C-G, Eriksson A L, Norén G, Ribbesjö, Rähn T, Schnell P-O, Tallstedt L, Sääf M, Thorén M (1989) Treatment of craniopharyngiomas - the stereotactic approach in an ten to twenty three years’ perspective. I. Surgical, radiological and ophthalmological aspects. Acta Neurochir (Wien) 99: 11–19CrossRefGoogle Scholar
- 4.Backlund E-O (1972) Studies on craniopharyngiomas III. Stereotaxic treatment with intracystic yttrium-90. Acta Chir Scand 139: 237–247Google Scholar
- 5.Backlund E-O (1972) Studies on craniopharyngiomas IV. Stereotaxic treatment with radiosurgery. Acta Chir Scand 139: 344–351Google Scholar
- 8.Degerblad M, Rähn T, Bergstrand G, Thorén M (1986) Long-term results of stereotactic radiosurgery to the pituitary gland in Cushing’s disease. Acta Endocrinol (Copenh) 112: 310–314Google Scholar
- 14.Thorén M, Rähn T, Hall K, Backlund E-O (1978) Treatment of pituitary dependent cushing’s syndrome with closed stereotactic radiosurgery by means of Co-60 gamma radiation. Acta Endocrinol (Copenh) 88: 7–17Google Scholar