• Je něco špatně v tomto záznamu ?

Morphological changes after radiosurgery for mesial temporal lobe epilepsy

Z. Vojtěch, H. Malíková, M. Syrůček, L. Krámská, J. Šroubek, V. Vladyka, R. Liščák,

. 2015 ; 157 (10) : 1783-91; discussion 1791-2. [pub] 20150816

Jazyk angličtina Země Rakousko

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc16020383

BACKGROUND: To review our experience with morphological developments during the long-term follow-up of patients treated by Gamma Knife radiosurgery for mesial temporal lobe epilepsy. METHOD: Between 1995 and 1999, we treated 14 patients with marginal doses of 24 Gy (n = 6) and 18-20 Gy (n = 8). Nine of these were operated on for insufficient seizure control. We reviewed seizure outcome and magnetic resonance images in both operated and unoperated patients and also re-examined histopathology specimens. RESULTS: Of the nine operated patients, two were Engel IIIA, one was IVA, five were IVB, and one was Engel IVC prior to surgery. At their final visit, five cases had become Engel class IA, one patient was ID, and two were IIC. In one patient the follow-up was not long enough for classification. Of the five unoperated patients, one was Engel class IB, one was IIIA, one IIB and one IVB at their final visit. Radionecrosis developed in 11 patients, occurring more often and earlier in those treated with higher doses. Collateral edema reached outside the temporal lobe in six patients, caused uncal herniation in two and intracranial hypertension in three. During longer follow-up, postnecrotic pseudocysts developed in 9 patients, and postcontrast enhancement persisted for 2.5-16 years after GKRS in all 14 patients. In five of them we detected its progression between 2 and 16 years after treatment. Signs of neoangiogenesis were found in two patients and microbleeds could be seen in five. Histopathology revealed blood vessel proliferation and macrophage infiltration. CONCLUSIONS: Early delayed complications and morphological signs suggesting a risk of development of late delayed complications are frequent after radiosurgery for mesial temporal lobe epilepsy. Together with its unproven antiseizure efficacy, these issues should be taken into account when planning future studies of this method.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc16020383
003      
CZ-PrNML
005      
20160725100100.0
007      
ta
008      
160722s2015 au f 000 0|eng||
009      
AR
024    7_
$a 10.1007/s00701-015-2525-2 $2 doi
024    7_
$a 10.1007/s00701-015-2525-2 $2 doi
035    __
$a (PubMed)26277098
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a au
100    1_
$a Vojtěch, Zdeněk $u Department of Neurology, Na Homolce Hospital, Roentgenova 2, 15030, Prague 5-Motol, Czech Republic. zdenek.vojtech@homolka.cz.
245    10
$a Morphological changes after radiosurgery for mesial temporal lobe epilepsy / $c Z. Vojtěch, H. Malíková, M. Syrůček, L. Krámská, J. Šroubek, V. Vladyka, R. Liščák,
520    9_
$a BACKGROUND: To review our experience with morphological developments during the long-term follow-up of patients treated by Gamma Knife radiosurgery for mesial temporal lobe epilepsy. METHOD: Between 1995 and 1999, we treated 14 patients with marginal doses of 24 Gy (n = 6) and 18-20 Gy (n = 8). Nine of these were operated on for insufficient seizure control. We reviewed seizure outcome and magnetic resonance images in both operated and unoperated patients and also re-examined histopathology specimens. RESULTS: Of the nine operated patients, two were Engel IIIA, one was IVA, five were IVB, and one was Engel IVC prior to surgery. At their final visit, five cases had become Engel class IA, one patient was ID, and two were IIC. In one patient the follow-up was not long enough for classification. Of the five unoperated patients, one was Engel class IB, one was IIIA, one IIB and one IVB at their final visit. Radionecrosis developed in 11 patients, occurring more often and earlier in those treated with higher doses. Collateral edema reached outside the temporal lobe in six patients, caused uncal herniation in two and intracranial hypertension in three. During longer follow-up, postnecrotic pseudocysts developed in 9 patients, and postcontrast enhancement persisted for 2.5-16 years after GKRS in all 14 patients. In five of them we detected its progression between 2 and 16 years after treatment. Signs of neoangiogenesis were found in two patients and microbleeds could be seen in five. Histopathology revealed blood vessel proliferation and macrophage infiltration. CONCLUSIONS: Early delayed complications and morphological signs suggesting a risk of development of late delayed complications are frequent after radiosurgery for mesial temporal lobe epilepsy. Together with its unproven antiseizure efficacy, these issues should be taken into account when planning future studies of this method.
650    _2
$a mladiství $7 D000293
650    _2
$a dospělí $7 D000328
650    _2
$a dítě $7 D002648
650    _2
$a epilepsie temporálního laloku $x chirurgie $7 D004833
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a magnetická rezonanční tomografie $7 D008279
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a radiochirurgie $x škodlivé účinky $7 D016634
650    _2
$a spánkový lalok $x patologie $x chirurgie $7 D013702
655    _2
$a časopisecké články $7 D016428
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Malíková, Hana $u Department of Radiodiagnostics, Na Homolce Hospital, Prague, Czech Republic.
700    1_
$a Syrůček, Martin $u Department of Pathology, Na Homolce Hospital, Prague, Czech Republic.
700    1_
$a Krámská, Lenka $u Department of Psychology, Na Homolce Hospital, Prague, Czech Republic.
700    1_
$a Šroubek, Jan $u Department of Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
700    1_
$a Vladyka, Vilibald $u Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
700    1_
$a Liščák, Roman $u Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
773    0_
$w MED00009022 $t Acta neurochirurgica $x 0942-0940 $g Roč. 157, č. 10 (2015), s. 1783-91; discussion 1791-2
856    41
$u https://pubmed.ncbi.nlm.nih.gov/26277098 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20160722 $b ABA008
991    __
$a 20160725100318 $b ABA008
999    __
$a ok $b bmc $g 1155053 $s 944911
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2015 $b 157 $c 10 $d 1783-91; discussion 1791-2 $e 20150816 $i 0942-0940 $m Acta neurochirurgica $n Acta Neurochir $x MED00009022
LZP    __
$a Pubmed-20160722

Najít záznam

Citační ukazatele

Možnosti archivace