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Essential tremor (ET) is identified as the most prevalent movement disorder, primarily characterized by tremors in both upper extremities. The spectrum of surgical options for ET includes gamma knife radiosurgery (GKRS) and other stereotactic radiosurgery (SRS) modalities. Despite the limitations of these options, SRS is deemed an essential and indispensable approach. Our research aimed to assess the safety and efficacy of SRS, such as GKRS, on tremor control and the spectrum of associated adverse events in the treatment of ET, also focusing on long term outcomes of the procedure. We systematically conducted an extensive search across esteemed databases, which included PubMed, Cochrane Library, Embase, and Web of Science. We included studies involving individuals diagnosed with ET who had undergone GRKS treatment. A proportional rate was used to evaluate the outcomes in a 95% confidence interval. We included 12 studies comprising 414 patients. The treatment success rate with SRS was 86.6% (95% CI: 72.4–100%). Conversely, the overall failure rate was 13.4% (95% CI: 0.00 to 27.6%). Notably, post-procedure complications were observed in 9.7% of patients (95% CI: 5.8–13.6%). A meta-analysis of five studies revealed a statistically significant reduction of tremor from the FTM scale after treatment with GKRS (MD -2.1; 95% CI -2.5 to -1.6; p < 0.01; I² = 81%). A meta-analysis of eight studies revealed a statistically significant reduction in writing tremor from the FTM scale after treatment with GKRS (MD -1.7; 95% CI -2.3 to -1.2; p < 0.01; I² = 93%). A meta-analysis of six studies revealed a statistically significant reduction in drawing tremor from the FTM scale after treatment with GKRS (MD -1.9; 95% CI -2.5 to -1.4; p < 0.01; I² = 80%). Finally, a meta-analysis of three studies revealed a statistically significant reduction in drinking tremor from the FTM scale after treatment with GKRS (MD -1.6; 95% CI -1.9 to -1.3; p < 0.01; I² = 11%). Our findings show a high success rate and low failure of GKRS for ET. Thus, GKRS is a seemingly effective and safe option for managing these patients. The importance of this research lies in its contribution to the evolving landscape of radiosurgery, providing a robust basis for the clinical application of GKRS. [ABSTRACT FROM AUTHOR]

Purpose: Gamma knife radiosurgery (GKRS) for orbital cavernous hemangioma (OCH) has emerged as a promising method due to its significant clinical improvement and low incidence of complications. This study aimed to evaluate the safety and efficacy of GKRS for the treatment of OCH. Methods: In accordance with the PRISMA framework, we searched PubMed, Cochrane Central, and Embase for studies reporting outcomes of GKRS for OCH. Studies reporting complications, visual improvement, proptosis, tumor reduction rate, and tumor progression rate for OCH following GKRS were included. Results: Six studies, out of 1856 search results, with 100 patients were included. Among them, only 5 minor complications were related to GKRS, including 3 with orbital pain and 2 with periorbital chemosis. Thus, the complication rate was 13% (95% CI, 7–25%). Visual acuity and visual field improvement rates after GKRS were 80% (95% CI, 63–96%) and 71% (95% CI, 47–95%) respectively. Proptosis improved in 94% of cases (95% CI, 83–100%). The tumor reduction rate was 77% after GKRS (95% CI, 69–85%). Conclusion: GKRS for OCH appears to be a safe technique, as evidenced by the rate of clinical improvement and radiological improvement. However, studies are limited by an absence of a control group. Additional studies are needed to evaluate the relative efficacy of GKRS as compared with alternative surgical modalities for OCH. [ABSTRACT FROM AUTHOR]

Purpose: Although rare, orbital cavernous hemangioma (OCH) is the most common benign orbital neoplasm in adults and may cause vision disturbance or loss due to optic nerve compression. The conventional treatment is surgical excision, which carries a risk of intraoperative nerve damage, whereas gamma knife radiosurgery (GKRS) can be a safe and effective alternative. Herein, we report the results of four patients with OCH treated with GKRS, and describe the method of treatment including the optic nerve protection. Methods: This retrospective study included four consecutive patients (three women, one man; mean age: 50 ± 14.7 years) with OCH treated with single-session GKRS between 2014 and 2020. Three patients had decreased visual acuity. During GKRS, the prescription dose delivered to the tumor margin was 12 Gy at the 55–58% isodose line. The dose to the optic nerve margin was < 12 Gy. Follow-up included sequential magnetic resonance imaging (MRI) and ophthalmological examinations at 6-month intervals. Results: The median follow-up period was 29.5 ± 23 months (range, 12–63 months). After GKRS, three patients with visual dysfunction had substantial vision improvement; the fourth patient continued to have normal vision without deterioration. Radiological outcomes after GKRS indicated an average tumor shrinkage of 70% ± 10.6% at the 6-month follow-up and 83% ± 2.64% at the 1-year follow-up. No adverse radiation effects were observed. Conclusions: GKRS for OCH achieved favorable clinical outcomes, with substantial tumor volume reduction. OCH can be diagnosed based on characteristic MRI findings. GKRS may be considered a treatment option for OCH in selected cases. [ABSTRACT FROM AUTHOR]