Chin L S, Lazio B E, Biggins T, Amin P
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Surg Neurol. 2000 May;53(5):498-502; discussion 502. doi: 10.1016/s0090-3019(00)00219-6.
Gamma knife radiosurgery (GKR) is a safe and effective alternative to surgery for intracranial lesions. Most studies evaluating toxicity after GKR have concentrated on the delayed radiation effects.
We retrospectively reviewed 835 consecutive GKR cases for early (within 7 days) neurological complications or death.
We identified a total of 18 patients (2.2%) who had a neurological event or death. Five (0.6%) patients developed new focal deficits, 12 (1.4%) patients experienced a seizure and there were three (0.4%) deaths. Two deaths were related to development of seizures and neurological deterioration. One death was caused by a respiratory arrest related to the patient's primary cancer. Of the five patients with neurological deficits, none had a persistent deficit. In two cases the neurological deficits were due to an increase in edema. Whether this occurred as a result of the gamma knife treatment or was the natural progression of the tumor is unclear.
Complications after GKR are uncommon and the risk of a permanent deficit arising from an acute neurological event is exceedingly low.
对于颅内病变，伽玛刀放射外科治疗（GKR）是一种安全有效的手术替代方法。大多数评估GKR后毒性的研究都集中在延迟放射效应上。
我们回顾性分析了连续835例接受GKR治疗的患者，以评估早期（7天内）神经并发症或死亡情况。
我们共确定了18例（2.2%）发生神经事件或死亡的患者。5例（0.6%）患者出现新的局灶性神经功能缺损，12例（1.4%）患者发生癫痫，3例（0.4%）患者死亡。2例死亡与癫痫发作和神经功能恶化有关。1例死亡是由与患者原发性癌症相关的呼吸骤停引起的。在5例有神经功能缺损的患者中，无一例存在持续性缺损。2例神经功能缺损是由于水肿加重所致。尚不清楚这是伽玛刀治疗的结果还是肿瘤的自然进展。
GKR后的并发症并不常见，急性神经事件导致永久性神经功能缺损的风险极低。
