Evaluation of Stereotactic Radiosurgery for Cerebellopontine Angle (CPA) Meningioma and Shwannoma after Microsurgical Decompression

CPA tumors are the most common neoplasms in the posterior fossa. After microsurgical decompression, the residual parts of meningiomas and shwannomas can be treated with stereotactic radiosurgery. Objective: The aim of the study is to evaluate long–term follow up of stereotactic radiosurgery after microsurgical decompression. Patients and Methods: Our study included a total of 32 patients with CPA meningioma and shwannoma, 23 cases with vestibular shwannoma and 9 cases with meningioma, these patients were subjected to microsurgical decompression and then treated with GK (gamma knife) and were followed up for at least 2 years. Results: Postoperative improvement occurred in 100% of patients with headache and in 82.5% of patients with ataxia and the postoperative complications were 7th nerve palsy occurred in 62.5% of cases, 9.4% had bulbar manifestations 3.1% had 5th nerve affection (pain), 18.75% needed re-operation due to presence of residual parts and recurrence of symptoms. Post gamma knife improvement occurred in 75% of patients presented with ataxia, and in 33% of patients presented by 5th nerve affection, and improvement occurred in single case presented by head ache, single case presented by vertigo and single case presented by bulbar symptoms. Complication after gamma knife were one case of hearing deterioration, one case needed re-surgery due to tumor regrowth, odema in one case and fits in one case. Radiologically 19 cases were less in size (59%), 9 cases retained the same size (28%) and 4 cases showed progressive increase in size (13%). Conclusion: (GKS) has achieved the goals of desired treatment in both aspects: long term tumor control and lowered morbidity.