Radiosurgery and Pathological Fundamentals Progress in Neurological Surgery Vol. 20 Series Editor L. Dade Lunsford, Pittsburgh, Pa. Radiosurgery and Pathological Fundamentals Volume Editors G.T. Szeifert, Budapest D. Kondziolka, Pittsburg, Pa. M. Levivier, Brussels L.D. Lunsford, Pittsburg, Pa. 131 figures, 66 in color, and 33 tables, 2007 Basel·Freiburg·Paris·London·New York· Bangalore·Bangkok·Singapore·Tokyo·Sydney George C. Tsokos Founder of the Series György T. Szeifert, MD, PhD Marc Levivier, MD, PhD National Institute of Neurosurgery and Centre Gamma Knife Department of Neurological Surgery Hôpital Académique Erasme Semmelweis University Université Libre de Bruxelles Budapest, Hungary Brussels, Belgium Douglas Kondziolka, MD, FACS, FRCS(C) L. Dade Lunsford, MD, FACS Center for Image-Guided Center for Image-Guided Neurosurgery Neurosurgery Department of Neurological Surgery Department of Neurological Surgery University of Pittsburgh University of Pittsburgh Pittsburgh, Pa., USA Pittsburgh, Pa., USA Library of Congress Cataloging-in-Publication Data Radiosurgery and pathological fundamentals / volume editors, G.T. Szeifert . . . [et al.]. p. ; cm. – (Progress in neurological surgery ; v. 20) Includes bibliographical references and indexes. ISBN-13: 978-3-8055-8200-1 (hardcover: alk. paper) ISBN-10: 3-8055-8200-5 (hardcover: alk. paper) 1. Radiosurgery. 2. Pathology, Surgical. I. Szeifert, G. T. (György T.) II. Series. [DNLM: 1. Radiosurgery–methods. 2. Brain–pathology. 3. Brain Diseases–surgery. W1 PR673 v.20 2007 / WL 368 R1293 2007] RD594.15.R338 2007 617.4(cid:1)81059–dc22 2006038289 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents®and Index Medicus. Disclaimer. The statements, options and data contained in this publication are solely those of the individ- ual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. © Copyright 2007 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free paper by Reinhardt Druck, Basel ISSN 0079–6492 ISBN-10: 3–8055–8200–5 ISBN-13: 3–8055–8200–1 Editor György T. Szeifert, MD, PhD National Institute of Neurosurgery and Department of Neurological Surgery, Semmelweis University, Budapest, Hungary Co-Editors Douglas Kondziolka, MD, Marc Levivier, MD, PhD L. Dade Lunsford, MD, FACS FACS, FRCS(C) Centre Gamma Knife, Department of Center for Image-Guided Center for Image-Guided Neurosurgery, Hôpital Académique Neurosurgery, Department of Neurosurgery, Department Erasme, Université Libre de Bruxelles, Neurological Surgery, UPMC of Neurological Surgery, Brussels, Belgium Presbyterian Hospital, University of UPMC Presbyterian Pittsburgh, Pittsburgh, Pa., USA Hospital, University of Pittsburgh, Pittsburgh, Pa., USA V List of Contributors Erik-Olof Backlund,MD,PhD Christopher Duma,MD,FACS Department of Neurosurgery Department of Neurosurgery exp. US plan 17 Hoag Memorial Hospital University Hospital Presbyterian, SE–581 85 Linköping (Sweden) 351 Hospital Drive, #401 E-Mail [email protected] Newport Beach, CA 92660 (USA) E-Mail [email protected] Nicholas M.Barbaro,MD Box 0112, Department of John C.Flickinger,MD,FACR Neurological Surgery Center for Image-Guided University of California at Neurosurgery San Francisco Department of Neurological Surgery San Francisco, CA 94143 (USA) University of Pittsburgh E-Mail [email protected] UPMC Presbyterian/Suite B-400 200 Lothrop Street Jacques Brotchi,MD,PhD Pittsburgh, PA 15213 (USA) President of the WFNS E-Mail [email protected] Department of Neurological Surgery Peter Gerszten,MD Hôpital Académique Erasme Department of Neurological Surgery Université Libre de Bruxelles University of Pittsburgh Medical Route de Lennik 808 Center BE–1070 Brussels (Belgium) 200 Lothrop Street, Suite B-400 E-Mail [email protected] Pittsburgh, PA 15213 (USA) E-Mail [email protected] Jenö Julow,MD,PhD Dan Leksell,MD Department of Neurological Surgery Karlavägen 63 St. John’s Hospital SE–114 49 Stockholm (Sweden) Diósárok u. 1–3 E-Mail [email protected] HU–1125 Budapest (Hungary) E-Mail [email protected] Marc Levivier,MD,PhD Centre Gamma Knife Andras A.Kemeny,MD,FRCS Hôpital Académique Erasme National Centre for Stereotactic Université Libre de Bruxelles Radiosurgery Route de Lennik 808 Department of Neurological Surgery BE–1070 Brussels (Belgium) Royal Hallamshire Hospital E-Mail [email protected] Sheffield S10 2JF (UK) E-Mail [email protected] Roman Lišc¤ák,MD Stereotactic and Radiation Tatsuya Kobayashi,MD,PhD Neurosurgery Department Nagoya Radiosurgery Center Hospital Na Homolce, Roentgenova 2 Nagoya Kyoritsu Hospital 1-172 Hokke, Nakagawa CZ–150 30 Prague 5 (Czech Republic) Nagoya, Aichi 454-0933 (Japan) E-Mail [email protected] E-Mail [email protected] L.Dade Lunsford,MD,FACS Douglas Kondziolka,MD,FACS, Center for Image-Guided FRCS(C) Neurosurgery Center for Image-Guided Department of Neurological Surgery Neurosurgery University of Pittsburgh Department of Neurological Surgery UPMC Presbyterian/Suite B-400 University of Pittsburgh 200 Lothrop Street UPMC Presbyterian/Suite B-400 Pittsburgh, PA 15213 (USA) 200 Lothrop Street E-Mail [email protected] Pittsburgh, PA 15213 (USA) E-Mail [email protected] Ottó Major,MD,PhD National Institute of Neurosurgery John Y.K.Lee,MD Amerikai út 57 Department of Neurosurgery HU–1145 Budapest (Hungary) University of Pennsylvania E-Mail [email protected] Penn Gamma Knife at Pennsylvania Hospital 330 South 9th Street Pennsylvania Neurological Institute 4th Floor Philadelphia, PA 19107 (USA) E-Mail [email protected] Contributors VII Nicolas Massager,MD Jason Sheehan,MD,PhD Centre Gamma Knife Lars Leksell Center for Gamma Hôpital Académique Erasme Knife Surgery Université Libre de Bruxelles Box 800-212 Route de Lennik 808 University of Virginia Health BE–1070 Brussels (Belgium) Sciences Center E-Mail [email protected] Charlottesville, VA 22908 (USA) E-Mail [email protected] Ajay Niranjan,MBBS,MS,MCh Center for Image-Guided Stéphane Simon,MS Neurosurgery Centre Gamma Knife Department of Neurological Surgery Hôpital Académique Erasme University of Pittsburgh Université Libre de Bruxelles UPMC Presbyterian/Suite B-400 Route de Lennik 808 200 Lothrop Street BE–1070 Brussels (Belgium) Pittsburgh, PA 15213 (USA) E-Mail [email protected] E-Mail [email protected] György T.Szeifert,MD,PhD István Nyáry,MD,PhD National Institute of Neurosurgery and National Institute of Neurosurgery and Department of Neurological Surgery Department of Neurological Surgery, Semmelweis University Semmelweis University Amerikai út 57 Amerikai út 57 HU–1145 Budapest (Hungary) HU–1145 Budapest (Hungary) E-Mail [email protected] E-Mail [email protected] David Wikler,MS Bruce E.Pollock,MD Centre Gamma Knife Department of Neurological Surgery Hôpital Académique Erasme Mayo Clinic Université Libre de Bruxelles 200 First Street N.W. Route de Lennik 808 Rochester, MN 55905-0001 (USA) BE–1070 Brussels (Belgium) E-Mail [email protected] E-Mail [email protected] Jean Régis,MD,PhD Masaaki Yamamoto,MD Centre Gamma Knife Katsuta Hospital, 5125-2 Nakane C.H.U. La Timone Hitachi’naka, Ibaraki 312-0011 264 rue Saint-Pierre (Japan) FR–13385 Marseille Cedex 05 E-Mail [email protected] (France) E-Mail [email protected] Contributors VIII Contents V Editors VI List of Contributors XV In Memoriam XVI Acknowledgement XVII Foreword Brotchi, J. (Brussels) XVIII Preface Lunsford, L.D. (Pittsburg, Pa.) Prologue XXI Gamma Knife – The Early Story: Memoirs of a Privileged Man Backlund, E.-O. (Linköping) Chapter 1 1 1. Introduction: The Contribution of Pathology to Radiosurgery Szeifert, G.T. (Budapest); Kondziolka, D.; Lunsford, L.D. (Pittsburgh, Pa.) Nyáry, I.; Hanzély, Z. (Budapest); Salmon, I.; Levivier, M. (Brussels) IX