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Gamma Knife Applications in and around the Pituitary Fossa

  • Jeremy C. Ganz

Abstract

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.

Keywords

Pituitary Adenoma Cavernous Sinus Gamma Knife Stereotactic Radiosurgery Gamma Knife Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Suggested Further Reading

  1. 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. 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
  3. 3.
    Sääf M, Thorén M, Bergstrand C-G, Norén G, Rähn T, Tallstedt L, Backlund E-O (1989) Treatment of craniopharyngiomas - the stereotactic approach in an ten to twenty three years’ perspective. I. Psychosocial situation and pituitary function. Acta Neurochir (Wien) 99: 97–103CrossRefGoogle Scholar
  4. 4.
    Backlund E-O (1972) Studies on craniopharyngiomas III. Stereotaxic treatment with intracystic yttrium-90. Acta Chir Scand 139: 237–247Google Scholar
  5. 5.
    Backlund E-O (1972) Studies on craniopharyngiomas IV. Stereotaxic treatment with radiosurgery. Acta Chir Scand 139: 344–351Google Scholar
  6. 6.
    Backlund E-O, Rähn T, Sarby B, De Schryver A, Wennerstrand (1972) Closed stereotaxic hypophysectomy by means of Co-60 radiation. Acta Radiol 11: 545–555CrossRefGoogle Scholar
  7. 7.
    Burch W (1983) A survey of results with transsphenoidal surgery in Cushing’s disease. New Eng J Med 308: 103–104PubMedCrossRefGoogle Scholar
  8. 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
  9. 9.
    Jeffcoate WJ (1988) Treating Cushing’s disease. Brit Med J 296: 227–228CrossRefGoogle Scholar
  10. 10.
    Nakane T, Kuwayama A, Watanabe M, Takahashi T, Kato T, Ichihara K, Kageyama N (1987) Long term results of transsphenoidal adenectomy in patients with Cushing’s disease. Neurosurgery 21: 218–222PubMedCrossRefGoogle Scholar
  11. 11.
    Ross EJ, Linch DC (1982) Cushing’s syndrome — killing disease: Discriminatory value of early signs and symptoms aiding early diagnosis. Lancet II: 646–649CrossRefGoogle Scholar
  12. 12.
    Rähn T, Thorén M, Hall K, Backlund E-O (1980) Stereotactic radio-surgery in Cushing’s disease acute radiation effects. Surg Neurol 14: 85–92PubMedGoogle Scholar
  13. 13.
    Thorén M, Rähn T, Guo W-Y, Werner S (1991) Stereotactic radiosurgery with cobalt-60 gamma unit in the treatment of growth hormone-producing pituitary tumors. Neurosurgery 29: 663–668PubMedCrossRefGoogle Scholar
  14. 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
  15. 15.
    Thorén M, Sääf M, Degerblad M, Rähn T, Norén G, Bergstrand CG, Tallstedt L, Backlund E-O (1988) Stereotactic irradiation for pituitary disease. Horm Res 30: 101–104PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1997

Authors and Affiliations

  • Jeremy C. Ganz
    • 1
  1. 1.Department of NeurosurgeryUniversity School of MedicineGrazAustria

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