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Twenty-seven patients with Graves' disease and progressive ophthalmopathy in an advanced stage underwent a transtemporal orbital decompression. The short-term results, i.e. within 2 months, of 48 operations are reported. Prior to the decompression, oral prednisolone, 20–60 mg daily, was given for 2 to 9 months to 15 patients. A minority of patients experienced temporary improvement during steroid administration. Cushing's syndrome was initiated in all patients. Prednisolone little altered the course of the progressive ophthalmopathy. Orbital decompression was followed by increasing visual acuity in 8/22 eyes with disturbed vision, a temporary decrease in 6 eyes, and unaltered visual acuity in the remaining 8 eyes. The decompression removed oedema of the optic disc in all eyes, cured glaucoma in 3 out of 5 patients, caused retraction of the eye bulbs by 5–6 mm in almost all operated cases, and increased compressibility of the orbital content from low (2–5 mm) to normal (6–10 mm) values. Surgery also relieved photophobia and lacrimation, but the effect on diplopia was uncertain. Generally, the decompression was followed by a rapid improvement of the orbital congestion and the patients recovered satisfactorily from the surgery.

A Leksell Gamma Knife has been used at Haukeland Hospital, Bergen, since October 1988. This is a powerful instrument in the treatment of some intracranial lesions. The article briefly describes the principles of treatment and the uses and limitations of the Gamma Knife.

Fourty-two consecutive patients with craniopharyngioma were treated by "stereotactic approach", i.e. preferentially stereotactic puncture and installation of colloid isotope into cystic tumours and external stereotactic single dose irradiation to solid tumour parts. In a minority of cases, such treatment was less suitable, and surgical removal and/or radiotherapy was used. There was no peroperative mortality. A long-term follow up (observation time 10-23 years) of the 31 patients alive indicated that they were socially well adapted with a high rate of fulltime work and a low rate of intercurrent disease. In spite of substitution therapy for pituitary insufficiency in most cases, the patients were subjectively seldom disturbed by their disease. Our results support a change in the choice of therapy for craniopharyngioma patients, from open neurosurgery to the less invasive stereotactic techniques.

A multi-modality treatment programme, where stereotactic methods were used preferentially, gave results in a consecutive series of craniopharyngiomas, not inferior to those reported after microsurgical removal. Fourty-two patients with a follow-up range of 10-23 years are reported.

(1972). Closed Stereotaxic Hypophysectomy by Means of 60Co Gamma Radiation. Acta Radiologica: Therapy, Physics, Biology: Vol. 11, No. 6, pp. 545-555.