{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:07:58Z","timestamp":1780463278038,"version":"3.54.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Supplement","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9\u201359 months).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4\u201324 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12\u201324 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.8.gks10977","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T01:11:50Z","timestamp":1542330710000},"page":"21-27","source":"Crossref","is-referenced-by-count":12,"title":["Gamma Knife surgery for low-flow cavernous sinus dural arteriovenous fistulas"],"prefix":"10.3171","volume":"113","author":[{"given":"Hyun Ho","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Wonju Christian Hospital, Yonsei University, Wonju Medical College, Wonju; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Hee","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, and Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kum","family":"Whang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wonju Christian Hospital, Yonsei University, Wonju Medical College, Wonju; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Soo","family":"Pyen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wonju Christian Hospital, Yonsei University, Wonju Medical College, Wonju; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Woo","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, and Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Gou","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, and Brain Research Institute, Yonsei 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of 60 patients","volume":"13","author":"Chung","year":"2002"},{"key":"b5-1130021","series-title":"Radiology","first-page":"671","article-title":"Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage","volume":"194","author":"Cognard","year":"1995"},{"key":"b6-1130021","series-title":"Radiother Oncol","first-page":"347","article-title":"An analysis of the dose-response for arteriovenous malformation radiosurgery and other factors affecting obliteration","volume":"63","author":"Flickinger","year":"2002"},{"key":"b7-1130021","series-title":"AJNR Am J Neuroradiol","first-page":"1081","article-title":"Radiosurgery as a treatment alternative for dural arteriovenous fistulas of the cavernous sinus","volume":"19","author":"Guo","year":"1998"},{"key":"b8-1130021","series-title":"Radiology","first-page":"55","article-title":"Intracranial dural arteriovenous malformations","volume":"105","author":"Houser","year":"1972"},{"key":"b9-1130021","series-title":"Prog Neurol Surg","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1159\/000163381","article-title":"Radiosurgery for dural arteriovenous fistula","volume":"22","author":"Kida","year":"2009"},{"key":"b10-1130021","series-title":"Neurosurgery","first-page":"836","article-title":"Transvenous treatment of carotid cavernous and dural arteriovenous fistulae: results for 31 patients and review of the literature","volume":"53","author":"Klisch","year":"2003"},{"issue":"5","key":"b11-1130021","series-title":"Neurosurg Focus","first-page":"E11","article-title":"The principles of skull base radiosurgery","volume":"24","author":"Kondziolka","year":"2008"},{"key":"b12-1130021","series-title":"Eye (Lond)","first-page":"1426","article-title":"Paradoxical worsening with superior ophthalmic vein thrombosis after gamma knife radiosurgery for dural arteriovenous fistula of cavernous sinus: a case report suggesting the mechanism of the phenomenon","volume":"20","author":"Lau","year":"2006"},{"key":"b13-1130021","series-title":"J Neurosurg","first-page":"43","article-title":"Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery","volume":"88","author":"Leber","year":"1998"},{"key":"b14-1130021","series-title":"J Neurosurg","first-page":"804","article-title":"The role of radiosurgery and particulate embolization in the treatment of dural arteriovenous fistulas","volume":"84","author":"Link","year":"1996"},{"key":"b15-1130021","series-title":"Neurosurgery","first-page":"1119","article-title":"Treatment for intracranial dural arteriovenous malformations: a meta-analysis from the English language literature","volume":"40","author":"Lucas","year":"1997"},{"key":"b16-1130021","series-title":"Am J Ophthalmol","first-page":"85","article-title":"Dural carotid cavernous fistula: definitive endovascular management and long-term follow-up","volume":"134","author":"Meyers","year":"2002"},{"key":"b17-1130021","series-title":"J Neurosurg","first-page":"42","article-title":"Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients","volume":"90","author":"Morita","year":"1999"},{"key":"b18-1130021","series-title":"Clin Oncol (R Coll Radiol)","first-page":"97","article-title":"Intracranial dural arteriovenous malformations: results of stereotactic radiosurgery in 17 patients","volume":"14","author":"O'Leary","year":"2002"},{"key":"b19-1130021","series-title":"Acta Neurochir (Wien)","first-page":"1265","article-title":"Complications associated with transvenous embolisation of cavernous dural arteriovenous fistula","volume":"141","author":"Oishi","year":"1999"},{"key":"b20-1130021","series-title":"Neurol Med Chir (Tokyo)","first-page":"477","article-title":"Gamma knife surgery for the treatment of spontaneous dural carotid-cavernous fistulas","volume":"43","author":"Onizuka","year":"2003"},{"key":"b21-1130021","series-title":"J Clin Neurosci","first-page":"744","article-title":"Multidisciplinary treatment of cavernous sinus dural arteriovenous fistulae with radiosurgery and embolization","volume":"12","author":"Pan","year":"2005"},{"key":"b22-1130021","series-title":"Am J Ophthalmol","first-page":"423","article-title":"The diagnosis and prognosis of atypical carotid-cavernous fistula (red-eyed shunt syndrome)","volume":"93","author":"Phelps","year":"1982"},{"key":"b23-1130021","series-title":"Neurosurgery","first-page":"459","article-title":"Stereotactic radiosurgery and particulate embolization for cavernous sinus dural arteriovenous fistulae","volume":"45","author":"Pollock","year":"1999"},{"key":"b24-1130021","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1427","article-title":"Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas","volume":"62","author":"Pollock","year":"2005"},{"issue":"Suppl 3","key":"b25-1130021","series-title":"J Neurosurg","first-page":"68","article-title":"Gamma knife radiosurgery in the management of cavernous sinus meningiomas","volume":"93","author":"Roche","year":"2000"},{"key":"b26-1130021","series-title":"Acta Neurochir (Wien)","first-page":"117","article-title":"Long-term observations in cases with spontaneous carotid-cavernous fistulas","volume":"90","author":"Sasaki","year":"1988"},{"key":"b27-1130021","series-title":"Ophthalmology","first-page":"205","article-title":"The syndrome of paradoxical worsening of dural-cavernous sinus arteriovenous malformations","volume":"94","author":"Sergott","year":"1987"},{"key":"b28-1130021","series-title":"J Neurosurg","first-page":"864","article-title":"Gamma knife surgery for dural arteriovenous fistula","volume":"104","author":"Sheehan","year":"2006"},{"key":"b29-1130021","series-title":"J 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