{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:23:40Z","timestamp":1787844220585,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Cavernous sinus hemangioma (CSH) are notoriously difficult to excise because of their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures. Radiosurgery offers an alternative treatment modality in cases of small and medium-sized CSH. However, no reports are available in the world literature detailing gamma knife radiosurgery (GKRS) in large (3\u20134 cm) and giant (&gt;4 cm) CSH. Two patients with giant CSH (Tumor volume was 72.2 and 99.8 cm\n                      <jats:sup>3<\/jats:sup>\n                      , respectively) were treated with frame-based fractionated GKRS (5 Gy \u00d7 5 #). The treatment was done with Leksell Perfexion with frame in situ and interfraction interval of 24 h. The tumor was engulfing the optic apparatus, and chiasma could not be separated delineated. The patients were followed at 3 months interval with clinic\u2013radiologic evaluation. Following GKRS, both patients showed remarkable clinical improvement in presenting complaints of headache and visual deterioration. Sixth nerve paresis recovered completely in case no. 1. Significant reduction in tumor volumes (85.1 and 75.6% respectively) was noticed in both the patients at 6 months follow-up radiology. Transient alopecia was noted in case 1 at 3 months follow-up that completely resolved by the 6 months. There was no complication till the last follow-up of 9 months. We report the first account of five fraction frame-based hypo fractionated GKRS for giant CSH. At an interval as short as 3 months, giant CSH shows remarkable clinical improvement. Primary hypofractionated GKRS may be considered an alternative effective modality in these difficult lesions with a favorable safety profile.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.317234","type":"journal-article","created":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T03:14:08Z","timestamp":1622344448000},"page":"724-728","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Primary Hypofractionated Gamma Knife Radiosurgery for Giant Cavernous Sinus Hemangiomas"],"prefix":"10.4103","volume":"69","author":[{"given":"Manjul","family":"Tripathi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghav","family":"Singla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Madan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Batish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag K","family":"Ahuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj K","family":"Tewari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Mohindra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ninad R","family":"Patil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushant","family":"Dutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Chauhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-38-20240907","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10143-018-0975-8","article-title":"Safety and efficacy of single-fraction gamma knife radiosurgery for benign confined cavernous sinus tumors: Our experience and literature review","volume":"43","author":"Tripathi","year":"2020","journal-title":"Neurosurg Rev"},{"key":"R2-38-20240907","doi-asserted-by":"crossref","first-page":"60","DOI":"10.3171\/2016.10.JNS16693","article-title":"Hypofractionated stereotactic radiosurgery: A new treatment strategy for giant cavernous sinus hemangiomas","volume":"128","author":"Wang","year":"2018","journal-title":"J Neurosurg"},{"key":"R3-38-20240907","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1227\/00006123-199201000-00018","article-title":"Cavernous sinus hemangiomas","volume":"30","author":"Linskey","year":"1992","journal-title":"Neurosurgery"},{"key":"R4-38-20240907","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1227\/01.NEU.0000255333.95532.13","article-title":"Extradural transcavernous approach to cavernous sinus hemangiomas","volume":"60","author":"Suri","year":"2007","journal-title":"Neurosurgery"},{"key":"R5-38-20240907","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1055\/s-2008-1065346","article-title":"Low-dose gamma knife radiosurgery for cavernous sinus hemangioma: Report of 3 cases and literature review","volume":"51","author":"Ivanov","year":"2008","journal-title":"Minim Invasive Neurosurg"},{"key":"R6-38-20240907","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1227\/01.NEU.0000378026.23116.E6","article-title":"Gamma knife surgery for cavernous hemangiomas in the cavernous sinus","volume":"67","author":"Chou","year":"2010","journal-title":"Neurosurgery"},{"key":"R8-38-20240907","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.4103\/0028-3886.241362","article-title":"Temporary noncicatricial focal alopecia following Gamma knife radiosurgery: Case series and review of literature","volume":"66","author":"Tripathi","year":"2018","journal-title":"Neurol India"},{"key":"R9-38-20240907","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.4103\/0028-3886.271242","article-title":"The safety and efficacy of bevacizumab for radiosurgery-Induced steroid-resistant brain edema; not the last part in the ship of theseus","volume":"67","author":"Tripathi","year":"2019","journal-title":"Neurol India"},{"key":"R10-38-20240907","doi-asserted-by":"crossref","first-page":"826","DOI":"10.4103\/neuroindia.NI_220_17","article-title":"Dose fractionated gamma knife radiosurgery for large arteriovenous malformations on daily or alternate day schedule outside the linear quadratic model: Proof of concept and early results. A substitute to volume fractionation","volume":"65","author":"Mukherjee","year":"2017","journal-title":"Neurol India"},{"key":"R11-38-20240907","doi-asserted-by":"crossref","first-page":"e136","DOI":"10.1016\/j.wneu.2019.07.090","article-title":"Safety and efficacy of primary multisession dose fractionated gamma knife radiosurgery for jugular paragangliomas","volume":"131","author":"Tripathi","year":"2019","journal-title":"World Neurosurg"}],"container-title":["Neurology India"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.317234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:15:37Z","timestamp":1787843737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.317234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/0028-3886.317234","relation":{},"ISSN":["0028-3886"],"issn-type":[{"value":"0028-3886","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}