Gamma Knife Radiosurgery for Pituitary Adenoma.

Case Summary:

50 years male from Baluchistan, underwent trans sphenoidal excision of adenoma  in March 19, 2022 presented with complaints of progressive loss of right vision for 1 year & decrease left vision for 1 year. Patient has no history of chemotherapy and radiation therapy. On clinical examination pt. is blind from right eye with left temporal defect. MRI brain with contrast dated January 06, 2023 shows heterogeneous enhancing abnormal signal intensity mass lesion seen in sellar & supra sellar region suggestive of adenoma. Histopathology dated April 05, 2022 shows adenoma. Perimetry dated January 05, 2023 shows left temporal defect. Hormones profile within normal range. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study December 15, 2023:

Patient visited the gamma knife center for the first follow up presented with recent MRI brain with contrast dated December 14, 2023 shows further regression in the size of tumor from 4.6cc to 3.6 cc when compared with previous MRI brain with contrast dated July 04, 2023, consistent with good response to Gamma Knife Therapy

 

Gamma Knife Radiosurgery for Craniopharyngioma.

Case Summary:

9 years old boy from Karachi, underwent insertion of VP shunt in May 27, 2023 & revision of shunt in June 09, 2023  presented with history of headache with vomiting . Patient has no history of radiation & chemotherapy. On clinical examination patient has no obvious deficit. CT brain with contrast dated June 06, 2023 shows lobulated solid / cystic hypo dense mass seen in supra sellar / sellar region causing significant compression over 3^rd ventricle resulting dilatation of left lateral ventricle with CSF seepage suggestive of Craniopharyngioma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study March 28,2024:

Patient consulted the gamma knife center for the first routine follow up presented with recent MRI Brain with contrast dated december 06,2023 shows significant reduction in the targeted lesion from 20.20cc to 8.033cc when compared with previous MRI Brain with contrast datedJune 06, 2023  ,consistent with good ongoing control of lesion.

 Gamma Knife Radiosurgery for Right Occipital High Grade Glioma :

Case Summary:

40 years of male from Islamabad, underwent craniotomy for Excision of SOL in August 22, 2023 presented with the complaints of headache for 3 months & no history of visual disturbances. The patient has no history of radiation & chemotherapy. On clinical examination patient has no obvious deficit. MRI brain with contrast dated September 15, 2023 shows intra axial enhancing mass lesion seen in the right occipital region with post-surgical changes suggestive of residual high grade glioma. Histopathology dated September 01, 2023 shows malignant neoplasm (glioma). Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study 19-01-2024:

Patient consulted the gamma knife center for the second routine follow up presented with recent MRI brain with contrast dated January 15,2024 shows almost complete resolution of the targeted lesion with post radiation changes when compared with previous MRI brain with contrast dated September 15, 2023  consistent with excellent control of lesion.

 Gamma Knife Radiosurgery for CA Thyroid with Right Ventricle & Right Parietal Metastases.

Case Summary:

46 years of female from Dir, CA Thyroid underwent total thyroidectomy in June 23, 2023 presented with the complaints of headache with vomiting for few months, vertigo for 3 months & numbness in right limbs after surgery. Patient has no history of radiation & chemotherapy. On clinical examination patient has no obvious deficit. MRI brain with contrast dated August 12, 2023 shows recurrent lesion in left lobe of thyroid & metastasis lesions in right parietal lobe & right lateral ventricle suggestive of brain metastasis. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study January 13,2024:

Patient consulted the gamma knife center for the first follow up presented with recent MRI brain with contrast dated January 12,2024 shows good resolution of the targeted metastasis, no new growth seen when compared with previous MRI brain with contrast dated August 12, 2023,consistent with good ongoing control of tumor.

 

Gamma Knife Radiosurgery for Left Temporo-Parietal Glioma.

Case Summary:

23 years young male from Islamabad, presented with complaints of numbness in right limbs for 7-8 months & two episodes of LOC for 10-15 second for 8 months.  Patient has no history of surgery, chemotherapy & radiation. On clinical examination young man is sitting comfortably has no obvious deficit. MRI brain dated September 26, 2022 shows re-demonstrated mass lesion noted in left temporo-parietal region with surrounding white matter edema and mass effect evident by compression of the ipsilateral lateral ventricle. MR Spectroscopy dated July 25, 2022, shows neoplastic etiology likely low grade glioma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study April 11,2023:

Patient consulted the gamma knife center for the first routine follow up presented with recent MRI Brain with contrast dated April 04,2023 shows significant regression in T2 hypertensity (from 66.9 to 42.5cc) when compared with previous MRI Brain with contrast dated September 26,2022 consistent with excellent response to gamma knife therapy.

Follow up Comparative Study March 20,2024:

Patient consulted the gamma knife center for the second routine follow up presented with recent MRI Brain with contrast dated March 09,2024 shows further sizeable reduction in the targeted lesion when compared with previous MRI Brain with contrast dated April 04,2023  consistent with ongoing control of tumor.

 

Gamma Knife Radiosurgery for Left Temporo Parietal Low Grade Glioma:

Case Summary:

43 years lady from Haripur Hazara, presented with complaints of impairment of memory for few years & fits for 2 weeks. Patient has no history of surgery, radiation & chemotherapy. On clinical examination middle age lady  has slightly affected working memory. MRI brain with contrast dated November 23, 2022 shows non enhancing abnormal signal intensity mass lesion seen in left temporal lobe insular cortex, inferior frontal lobe & part of parietal lobe suggestive of low grade glioma. MRS shows elevated choline with reduced NAA & Cr peak suggestive of neoplastic lesion. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up Comparative Study July 11,2023:

Patient visited the gamma knife center for the first follow up presented with recent MRI brain with contrast dated June 19,2023 shows interval decrease of the targeted lesion in T2 hyper intensity signal when compared with previous MRI brain with contrast dated November 23,2022 , consistent with good ongoing control of tumor.

 Gamma Knife Radiosurgery for Nasal Angio Fibroma with Intra cranial Extension:

Case Summary:

14 years boy from Sanghar, underwent excision biopsy of tumor in March 26, 2022 by Dr. Imran presented with complaints of nasal blockage & nasal discharge for 1 year. The patient has no history of radiation & chemotherapy. On clinical examination boy is sitting on a chair comfortably has no obvious deficit. MRI brain & Para nasal sinuses dated January 10, 2022 shows a large infiltrating abnormally enhancing soft tissue intensity tumor is appreciated predominantly arising from the right lateral wall of naso pharynx close to the sphenopalantine fossa with extra axial intracranial extension. Histopathology dated April 08, 2022 shows nasal angiofibroma. Risks of GKSRS have been explained. Written and valid consent obtained to proceed.

Follow up comparative study dated June 14,2023 :

Patient visited the gamma knife center for the first routine follow up presented with recent MRI brain with contrast dated June 14, 2023 shows 50% regression in the targeted lesion when compared with previous MRI brain with contrast dated January 10, 2022 consistent with good ongoing control of lesion.

Follow up comparative study dated January 12,2024 :

Patient visited the gamma knife center for the second routine follow up presented with recent MRI brain with contrast dated January 11, 2024 shows further regression in the targeted lesion when compared with previous MRI brain with contrast dated June 14, 2023  consistent with good ongoing control of lesion.