{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:58:45Z","timestamp":1792403925619,"version":"4.4.0"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,1]]},"abstract":"<jats:p content-type=\"fine-print\">As the number of patients treated with stereotactic radiosurgery increases, it becomes particularly important to define with precision adverse effects on distinct structures of the nervous system.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic>This study was designed to assess the dose\u2014response tolerance of the visual pathways and cranial nerves after exposure of the cavernous sinus to radiation.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic>A total of 66 sites in the visual system and 210 cranial nerves of the middle cranial fossa were investigated in 50 patients who had undergone gamma knife treatment for benign skull base tumors. The mean follow-up period was 40 months (range 24\u201360 months). Follow-up examinations consisted of neurological, neuroradiological, and neuroophthalmological evaluations.<\/jats:p><jats:p content-type=\"fine-print\">The actuarial incidence of optic neuropathy was zero for patients who received a radiation dose of less than 10 Gy, 26.7% for patients receiving a dose in the range of 10 to less than 15 Gy, and 77.8% for those who received doses of 15 Gy or more (p &lt; 0.0001). Previously impaired vision improved in 25.8% and was unchanged in 51.5% of patients. No sign of neuropathy was seen in patients whose cranial nerves of the cavernous sinus received radiation doses of between 5 and 30 Gy. Because tumor control appeared to have been achieved in 98% of the patients, the deterioration in visual function cannot be attributed to tumor progression.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic>The structures of the visual pathways (the optic nerve, chiasm, and tract) exhibit a much higher sensitivity to single-fraction radiation than other cranial nerves, and their particular dose\u2014response characteristics can be defined. In contrast, the oculomotor and trigeminal nerves have a much higher dose tolerance.<\/jats:p>","DOI":"10.3171\/jns.1998.88.1.0043","type":"journal-article","created":{"date-parts":[[2009,6,16]],"date-time":"2009-06-16T02:25:54Z","timestamp":1245119154000},"page":"43-50","source":"Crossref","is-referenced-by-count":419,"title":["Dose\u2014response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery"],"prefix":"10.3171","volume":"88","author":[{"given":"Klaus A.","family":"Leber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jutta","family":"Bergl\u00f6ff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Pendl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/0360-3016(77)90046-3","volume":"2","author":"Aristizabal S","year":"1977","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1979.tb02103.x"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.3109\/01658109609044633"},{"key":"b4","first-page":"98","volume":"13","author":"Borruat FX","year":"1993","journal-title":"J Clin Neuroophthalmology"},{"key":"b5","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","volume":"34","author":"Cox DR","year":"1972","journal-title":"J R Stat Soc B"},{"key":"b6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/brain\/84.1.85","volume":"84","author":"Crompton MR","year":"1961","journal-title":"Brain"},{"key":"b7","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2214\/ajr.150.1.189","volume":"150","author":"Di Chiro G","year":"1987","journal-title":"AJR"},{"key":"b8","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/0360-3016(90)90557-Z","volume":"19","author":"Dowsett RJ","year":"1990","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"b9","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1227\/00006123-199305000-00001","volume":"32","author":"Duma CM","year":"1993","journal-title":"Neurosurgery"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(90)90146-B"},{"key":"b11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1148\/radiology.185.1.1523337","volume":"185","author":"Goldsmith BJ","year":"1992","journal-title":"Radiology"},{"key":"b12","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/S0161-6420(90)32536-8","volume":"97","author":"Guy J","year":"1990","journal-title":"Ophthalmology"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1991.74.3.0426"},{"key":"b14","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/S0161-6420(90)32537-X","volume":"97","author":"Guy J","year":"1990","journal-title":"Ophthalmology"},{"key":"b15","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/S0161-6420(86)33617-0","volume":"93","author":"Guy J","year":"1986","journal-title":"Ophthalmology"},{"key":"b16","first-page":"208","volume":"103","author":"Hammer HM","year":"1983","journal-title":"Trans Ophthalmol Soc UK"},{"key":"b17","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1148\/120.1.167","volume":"120","author":"Harris JR","year":"1976","journal-title":"Radiology"},{"key":"b18","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1259\/0007-1285-43-507-161","volume":"3","author":"Hopewell JW","year":"1970","journal-title":"Br J Radiol"},{"key":"b19","first-page":"235","volume":"13","author":"Hudgins PA","year":"1992","journal-title":"AJNR"},{"key":"b20","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/BF00699643","volume":"36","author":"Husain MM","year":"1976","journal-title":"Acta Neuropathol"},{"key":"b21","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/0167-8140(94)90005-1","volume":"30","author":"Jiang GL","year":"1994","journal-title":"Radiother Oncol"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.2307\/2281868"},{"key":"b23","first-page":"191","volume-title":"Evaluation of Chemotherapeutic Agents.","author":"Karnofsky DA","year":"1949"},{"key":"b24","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/BF00919103","volume":"231","author":"Kellner U","year":"1993","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(85)33898-8"},{"key":"b26","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1991.74.4.0552"},{"key":"b27","first-page":"3","volume-title":"Radiosurgery. 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