Acta Neurochirurgica

, Volume 160, Issue 12, pp 2367–2378 | Cite as

Radiosurgery and fractionated radiotherapy for cavernous sinus meningioma: a systematic review and meta-analysis

  • Henri-Arthur LeroyEmail author
  • Constantin Tuleasca
  • Nicolas Reyns
  • Marc Levivier
Review Article - Tumor - Meningioma
Part of the following topical collections:
  1. Tumor – Meningioma



Radiosurgery (RS) and fractionated radiotherapy (FRT) are part of the therapeutic armamentarium for the management of cavernous sinus meningiomas. We propose a systematic review of the local tumor control and clinical outcomes after monofractionated radiosurgical treatment, including gamma knife radiosurgery (GKRS) and linear accelerator (Linac RS), or fractionated radiotherapy.

Materials and Methods

The current review and meta-analysis adhered to the PRISMA guidelines. We performed a search in PubMed, Embase, and Medline based on the following mesh terms, used alone or in diverse combinations, in both title and abstract: “cavernous sinus,” “meningioma,” “radiosurgery,” “gamma knife,” “linac,” “cyberknife,” and “radiotherapy”. We screened 425 studies. We selected 36 studies, matching all selection criteria: 24 for GK, 5 for Linac, and 7 for FRT.


Were included 2817 patients (GKRS, n = 2047, LinacRS, n = 350, FRT, n = 420). Half of patients benefited from upfront RS or FRT; the other half benefited from adjuvant RS or FRT (combined approach or tumor recurrence). The mean gross target volume (GTV) was smaller for RS as compared to FRT (p = 0.07). The median marginal doses were 13.9 Gy (range, 11 to 28) for GKRS and 14 Gy (range, 12.8 to 17.7) for LinacRS. For FRT, patients received a mean dose of 51.2 Gy (25.5 fractions, 1.85 Gy each). The mean overall follow-up values were 48 months (range, 15 to 89) for GKRS, 69 months (range, 46 to 87) for Linac, and 59.5 months (range, 33 to 83) for FRT. PFS at 5 years for GKRS, LinacRS, and FRT were respectively 93.6%, 95.6%, and 97.4% (p = 0.32, the Kruskal-Wallis). Monofractionated treatments (GKRS and LinacRS) induced more tumor volume regression than FRT (p = 0.001). Tumor recurrence or progression ranged between 3 and 5.8%, without statistically significant differences between modalities (p > 0.05). Trigeminal symptoms improved in approximately 54%, and III-IV-VI cranial nerves (CN) palsies improved in approximately 45%. After GKRS, visual acuity improved in 21% (not enough data available for other modalities). De novo deficits occurred in 5 to 7.5%. Adverse radiation effects appeared in 4.6 to 9.3% (all techniques pooled).


RS achieved a twice-higher rate of tumor volume regression than FRT. GKRS series reported an improvement in visual acuity in 21% of the cases. GKRS, Linac, and FRT provided similar clinical post therapeutic outcomes for the trigeminal and oculomotor CN.


Cavernous sinus meningioma Radiosurgery Radiotherapy Gamma knife 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name of institute/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Wiemels J, Wrensch M, Claus EB (2010) Epidemiology and etiology of meningioma. J Neuro-Oncol 99:307–314CrossRefGoogle Scholar
  2. 2.
    Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, von Deimling A, Stavrinou P, Lefranc F, Lund-Johansen M, Moyal EC, Brandsma D, Henriksson R, Soffietti R, Weller M (2016) EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 17:e383–e391CrossRefGoogle Scholar
  3. 3.
    Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39CrossRefGoogle Scholar
  4. 4.
    DeMonte F, Smith HK, al-Mefty O (1994) Outcome of aggressive removal of cavernous sinus meningiomas. J Neurosurg 81:245–251CrossRefGoogle Scholar
  5. 5.
    O’Sullivan MG, van Loveren HR, Tew JM Jr (1997) The surgical resectability of meningiomas of the cavernous sinus. Neurosurgery 40:238–244 discussion 245–237CrossRefGoogle Scholar
  6. 6.
    Sindou M, Wydh E, Jouanneau E, Nebbal M, Lieutaud T (2007) Long-term follow-up of meningiomas of the cavernous sinus after surgical treatment alone. J Neurosurg 107:937–944CrossRefGoogle Scholar
  7. 7.
    Franzin A, Vimercati A, Medone M, Serra C, Marzoli SB, Forti M, Gioia L, Valle M, Picozzi P (2007) Neuroophthalmological evaluation after Gamma Knife surgery for cavernous sinus meningiomas. Neurosurg Focus 23Google Scholar
  8. 8.
    Kano H, Park K-JJ, Kondziolka D, Iyer A, Liu X, Tonetti D, Flickinger JC, Lunsford LD (2013) Does prior microsurgery improve or worsen the outcomes of stereotactic radiosurgery for cavernous sinus meningiomas? Neurosurgery 73:401–410CrossRefGoogle Scholar
  9. 9.
    Pollock BE, Stafford SL, Link MJ, Garces YI, Foote RL (2013) Single-fraction radiosurgery of benign cavernous sinus meningiomas. J Neurosurg 119:675–682CrossRefGoogle Scholar
  10. 10.
    Dufour H, Muracciole X, Métellus P, Régis J, Chinot O, Grisoli F (2001) Long-term tumor control and functional outcome in patients with cavernous sinus meningiomas treated by radiotherapy with or without previous surgery: is there an alternative to aggressive tumor removal? Neurosurgery 48:285PubMedGoogle Scholar
  11. 11.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6:e1000100CrossRefGoogle Scholar
  12. 12.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8:336–341CrossRefGoogle Scholar
  13. 13.
    Duma CM, Lunsford LD, Kondziolka D, Harsh GR, Flickinger JC (1993) Stereotactic radiosurgery of cavernous sinus meningiomas as an addition or alternative to microsurgery. Neurosurgery 32:699CrossRefGoogle Scholar
  14. 14.
    Hafez RF, Morgan MS, Fahmy OM (2015) Stereotactic Gamma Knife surgery safety and efficacy in the management of symptomatic benign confined cavernous sinus meningioma. Acta Neurochir 157:1559–1564CrossRefGoogle Scholar
  15. 15.
    Hasegawa T, Kida Y, Yoshimoto M, Koike J, Iizuka H, Ishii D (2007) Long-term outcomes of Gamma Knife surgery for cavernous sinus meningioma. J Neurosurg 107:745–751CrossRefGoogle Scholar
  16. 16.
    Hayashi M, Chernov M, Tamura N, Tamura M, Horiba A, Konishi Y, Okada Y, Muragaki Y, Iseki H, Takakura K (2012) Gamma knife radiosurgery for benign cavernous sinus tumors: treatment concept and outcomes in 120 cases. Neurol Med Chir 52:714–723CrossRefGoogle Scholar
  17. 17.
    Iwai Y, Yamanaka K, Ishiguro T (2003) Gamma knife radiosurgery for the treatment of cavernous sinus meningiomas. Neurosurgery 52:517CrossRefGoogle Scholar
  18. 18.
    Kobayashi T, Kida Y, Mori Y (2001) Long-term results of stereotactic gamma radiosurgery of meningiomas. Surg Neurol 55:325–331CrossRefGoogle Scholar
  19. 19.
    Lee JY, Niranjan A, McInerney J, Kondziolka D, Flickinger JC, Lunsford LD (2002) Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas. J Neurosurg 97:65–72CrossRefGoogle Scholar
  20. 20.
    Liscák R, Simonová G, Vymazal J, Janousková L, Vladyka V (1999) Gamma knife radiosurgery of meningiomas in the cavernous sinus region. Acta Neurochir 141:473–480CrossRefGoogle Scholar
  21. 21.
    Liu ALL, Wang C, Sun S, Wang M, Liu P (2005) Gamma knife radiosurgery for tumors involving the cavernous sinus. Stereotact Funct Neurosurg 83:45–51CrossRefGoogle Scholar
  22. 22.
    Malik I, Rowe JG, Walton L, Radatz MW, Kemeny AA (2005) The use of stereotactic radiosurgery in the management of meningiomas. Br J Neurosurg 19:13–20CrossRefGoogle Scholar
  23. 23.
    Maruyama K, Shin M, Kurita H, Kawahara N, Morita A, Kirino T (2004) Proposed treatment strategy for cavernous sinus meningiomas: a prospective study. Neurosurgery 55:1068–1075CrossRefGoogle Scholar
  24. 24.
    Nicolato A, Foroni R, Alessandrini F, Bricolo A, Gerosa M (2002) Radiosurgical treatment of cavernous sinus meningiomas: experience with 122 treated patients. Neurosurgery 51:1153CrossRefGoogle Scholar
  25. 25.
    Pollock BE, Stafford SL (2005) Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas. Int J Radiat Oncol Biol Phys 62:1427–1431CrossRefGoogle Scholar
  26. 26.
    Roche PH, Régis J, Dufour H, Fournier HD, Delsanti C, Pellet W, Grisoli F, Peragut JC (2000) Gamma knife radiosurgery in the management of cavernous sinus meningiomas. J Neurosurg 93(Suppl 3):68–73PubMedGoogle Scholar
  27. 27.
    Shin M, Kurita H, Sasaki T, Kawamoto S, Tago M, Kawahara N, Morita A, Ueki K, Kirino T (2001) Analysis of treatment outcome after stereotactic radiosurgery for cavernous sinus meningiomas. J Neurosurg 95:435–439CrossRefGoogle Scholar
  28. 28.
    Skeie BS, Enger PO, Skeie GO, Thorsen F, Pedersen PHH (2010) Gamma knife surgery of meningiomas involving the cavernous sinus: long-term follow-up of 100 patients. Neurosurgery 66:661CrossRefGoogle Scholar
  29. 29.
    Williams BJ, Yen CP, Starke RM, Basina B, Nguyen J, Rainey J, Sherman JH, Schlesinger D, Sheehan JP (2011) Gamma Knife surgery for parasellar meningiomas: long-term results including complications, predictive factors, and progression-free survival. J Neurosurg 114:1571–1577CrossRefGoogle Scholar
  30. 30.
    Zada G, Pagnini PG, Yu C, Erickson KT, Hirschbein J, Zelman V, Apuzzo ML (2010) Long-term outcomes and patterns of tumor progression after gamma knife radiosurgery for benign meningiomas. Neurosurgery 67:322CrossRefGoogle Scholar
  31. 31.
    Correa SFF, Marta GN, Teixeira MJ (2014) Neurosymptomatic carvenous sinus meningioma: a 15-years experience with fractionated stereotactic radiotherapy and radiosurgery. Radiation oncology (London, England) 9:27CrossRefGoogle Scholar
  32. 32.
    Chang D, Adler R, Martin DP (1998) LINAC Radiosurgery for Cavernous Sinus Meningiomas. Stereotact Funct Neurosurg 71:43–50CrossRefGoogle Scholar
  33. 33.
    dos Santos MA, de Salcedo JBB, Gutiérrez Diaz JAA, Calvo FA, Samblás J, Marsiglia H, Sallabanda K (2011) Long-term outcomes of stereotactic radiosurgery for treatment of cavernous sinus meningiomas. Int J Radiat Oncol Biol Phys 81:1436–1441CrossRefGoogle Scholar
  34. 34.
    Kimball MM, Friedman WA, Foote KD, Bova FJ, Chi YY (2009) Linear accelerator radiosurgery for cavernous sinus meningiomas. Stereotact Funct Neurosurg 87:120–127CrossRefGoogle Scholar
  35. 35.
    Spiegelmann R, Cohen ZR, Nissim O, Alezra D, Pfeffer R (2010) Cavernous sinus meningiomas: a large LINAC radiosurgery series. J Neuro-Oncol 98:195–202CrossRefGoogle Scholar
  36. 36.
    Brell M, Villà S, Teixidor P, Lucas A, Ferrán E, Marín S, Acebes J (2006) Fractionated stereotactic radiotherapy in the treatment of exclusive cavernous sinus meningioma: functional outcome, local control, and tolerance. Surg Neurol 65:28–33CrossRefGoogle Scholar
  37. 37.
    Haghighi N, Seely A, Paul E, Dally M (2015) Hypofractionated stereotactic radiotherapy for benign intracranial tumours of the cavernous sinus. J Clin Neurosci 22:1450–1455CrossRefGoogle Scholar
  38. 38.
    Litré C, Colin P, Noudel R, Peruzzi P, Bazin A, Sherpereel B, Bernard M, Rousseaux P (2009) Fractionated stereotactic radiotherapy treatment of cavernous sinus meningiomas: a study of 100 cases. Int J Radiat Oncol Biol Phys 74:1012–1017CrossRefGoogle Scholar
  39. 39.
    Metellus P, Batra S, Karkar S, Kapoor S, Weiss S, Kleinberg L, Rigamonti D (2010) Fractionated conformal radiotherapy in the management of cavernous sinus meningiomas: long-term functional outcome and tumor control at a single institution. Int J Radiat Oncol Biol Phys 78:836–843CrossRefGoogle Scholar
  40. 40.
    Milker-Zabel S, Bois A, Huber P, Schlegel W, Debus J (2006) Fractionated stereotactic radiation therapy in the management of benign cavernous sinus meningiomas : long-term experience and review of the literature. Strahlenther Onkol 182:635–640CrossRefGoogle Scholar
  41. 41.
    Selch MT, Ahn E, Laskari A, Lee SP, Agazaryan N, Solberg TD, Cabatan-Awang C, Frighetto L, Desalles A (2004) Stereotactic radiotherapy for treatment of cavernous sinus meningiomas. International Journal of Radiation Oncology*Biology*Physics 59:101–111CrossRefGoogle Scholar
  42. 42.
    Soldà F, Wharram B, De Ieso PB, Bonner J, Ashley S, Brada M (2013) Long-term efficacy of fractionated radiotherapy for benign meningiomas. Radiother Oncol 109:330–334CrossRefGoogle Scholar
  43. 43.
    Kuo JS, Chen JC, Yu C, Zelman V, Giannotta SL, Petrovich Z, MacPherson D, Apuzzo ML (2004) Gamma knife radiosurgery for benign cavernous sinus tumors: quantitative analysis of treatment outcomes. Neurosurgery 54:1385CrossRefGoogle Scholar
  44. 44.
    Metellus P, Regis J, Muracciole X, Fuentes S, Dufour H, Nanni I, Chinot O, Martin P-MM, Grisoli F (2005) Evaluation of fractionated radiotherapy and gamma knife radiosurgery in cavernous sinus meningiomas: treatment strategy. Neurosurgery 57:873CrossRefGoogle Scholar
  45. 45.
    Fariselli L, Biroli A, Signorelli A, Broggi M, Marchetti M, Biroli F (2016) The cavernous sinus meningiomas’ dilemma: Surgery or stereotactic radiosurgery? Rep Pract Oncol Radiother 21:379–385CrossRefGoogle Scholar
  46. 46.
    Sughrue ME, Rutkowski MJ, Aranda D, Barani IJ, McDermott MW, Parsa AT (2010) Factors affecting outcome following treatment of patients with cavernous sinus meningiomas. J Neurosurg 113:1087–1092CrossRefGoogle Scholar
  47. 47.
    Kaprealian T, Raleigh DR, Sneed PK, Nabavizadeh N, Nakamura JL, McDermott MW (2016) Parameters influencing local control of meningiomas treated with radiosurgery. J Neuro-Oncol 128:357–364CrossRefGoogle Scholar
  48. 48.
    Sandstrom H, Nordstrom H, Johansson J, Kjall P, Jokura H, Toma-Dasu I (2014) Variability in target delineation for cavernous sinus meningioma and anaplastic astrocytoma in stereotactic radiosurgery with Leksell Gamma Knife Perfexion. Acta Neurochir 156:2303–2312 discussion 2312–2303CrossRefGoogle Scholar
  49. 49.
    Kondziolka D, Flickinger JC, Perez B (1998) Judicious resection and/or radiosurgery for parasagittal meningiomas: outcomes from a multicenter review. Gamma Knife Meningioma Study Group. Neurosurgery 43:405–413 discussion 413-404 CrossRefGoogle Scholar
  50. 50.
    Rogers L, Barani I, Chamberlain M, Kaley TJ, McDermott M, Raizer J, Schiff D, Weber DC, Wen PY, Vogelbaum MA (2015) Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review J Neurosurg 122:4–23CrossRefGoogle Scholar
  51. 51.
    Kaul D, Badakhshi H, Gevaert T, Pasemann D, Budach V, Tuleasca C, Gruen A, Prasad V, Levivier M, Kufeld M (2015) Dosimetric comparison of different treatment modalities for stereotactic radiosurgery of meningioma. Acta Neurochir 157:559–563 discussion 563–554CrossRefGoogle Scholar
  52. 52.
    Kaul D, Badakhshi H, Gevaert T, Pasemann D, Budach V, Tuleasca C, Gruen A, Prasad V, Levivier M, Kufeld M (2015) Erratum to: dosimetric comparison of different treatment modalities for stereotactic radiosurgery of meningioma. Acta Neurochir 157:565CrossRefGoogle Scholar
  53. 53.
    Leavitt JA, Stafford SL, Link MJ, Pollock BE (2013) Long-term evaluation of radiation-induced optic neuropathy after single-fraction stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 87:524–527CrossRefGoogle Scholar
  54. 54.
    Marchetti M, Bianchi S, Pinzi V, Tramacere I, Fumagalli ML, Milanesi IM, Ferroli P, Franzini A, Saini M, DiMeco F, Fariselli L (2016) Multisession radiosurgery for sellar and parasellar benign meningiomas: long-term tumor growth control and visual outcome. Neurosurgery 78:638–646CrossRefGoogle Scholar
  55. 55.
    Navarria P, Pessina F, Cozzi L, Clerici E, Villa E, Ascolese AM, De Rose F, Comito T, Franzese C, D’Agostino G, Lobefalo F, Fogliata A, Reggiori G, Fornari M, Tomatis S, Bello L, Scorsetti M (2015) Hypofractionated stereotactic radiation therapy in skull base meningiomas. J Neuro-Oncol 124:283–289CrossRefGoogle Scholar
  56. 56.
    Stieler F, Wenz F, Abo-Madyan Y, Schweizer B, Polednik M, Herskind C, Giordano FA, Mai S (2016) Adaptive fractionated stereotactic Gamma Knife radiotherapy of meningioma using integrated stereotactic cone-beam-CT and adaptive re-planning (a-gkFSRT). Strahlenther OnkolGoogle Scholar
  57. 57.
    Nakazawa H, Mori Y, Komori M, Tsugawa T, Shibamoto Y, Kobayashi T, Hashizume C, Uchiyama Y, Hagiwara M (2014) Simulational study of a dosimetric comparison between a Gamma Knife treatment plan and an intensity-modulated radiotherapy plan for skull base tumors. J Radiat Res 55:518–526CrossRefGoogle Scholar
  58. 58.
    De Jesus O, Sekhar LN, Parikh HK, Wright DC, Wagner DP (1996) Long-term follow-up of patients with meningiomas involving the cavernous sinus: recurrence, progression, and quality of life. Neurosurgery 39:915–919 discussion 919–920PubMedGoogle Scholar
  59. 59.
    Abdel-Aziz KM, Froelich SC, Dagnew E, Jean W, Breneman JC, Zuccarello M, van Loveren HR, Tew JM, Jr. (2004) Large sphenoid wing meningiomas involving the cavernous sinus: conservative surgical strategies for better functional outcomes. Neurosurgery 54:1375–1383; discussion 1383–1374CrossRefGoogle Scholar
  60. 60.
    Park HJ, Griffin RJ, Hui S, Levitt SH, Song CW (2012) Radiation-induced vascular damage in tumors: implications of vascular damage in ablative hypofractionated radiotherapy (SBRT and SRS). Radiat Res 177:311–327CrossRefGoogle Scholar
  61. 61.
    Song CW, Kim M-SS, Cho LC, Dusenbery K, Sperduto PW (2014) Radiobiological basis of SBRT and SRS. Int J Clin Oncol 19:570–578CrossRefGoogle Scholar
  62. 62.
    Morita A, Coffey RJ, Foote RL, Schiff D, Gorman D (1999) Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients. J Neurosurg 90:42–49CrossRefGoogle Scholar
  63. 63.
    Lee C-CC, Sheehan JP (2016) Advances in Gamma Knife radiosurgery for pituitary tumors. Cur Opin Endocrinol Diabetes Obes 23:331–338CrossRefGoogle Scholar
  64. 64.
    Sheehan JP, Starke RM, Mathieu D, Young B, Sneed PK, Chiang VL, Lee JY, Kano H, Park K-JJ, Niranjan A, Kondziolka D, Barnett GH, Rush S, Golfinos JG, Lunsford LD (2013) Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. J Neurosurg 119:446–456CrossRefGoogle Scholar
  65. 65.
    Xu Z, Ellis S, Lee C-CC, Starke RM, Schlesinger D, Lee Vance M, Lopes MB, Sheehan J (2014) Silent corticotroph adenomas after stereotactic radiosurgery: a case-control study. Int J Radiat Oncol Biol Phys 90:903–910CrossRefGoogle Scholar
  66. 66.
    Pichierri A, Santoro A, Raco A, Paolini S, Cantore G, Delfini R (2009) Cavernous sinus meningiomas: retrospective analysis and proposal of a treatment algorithm. Neurosurgery 64:1090CrossRefGoogle Scholar
  67. 67.
    Abeloos L, Levivier M, Devriendt D, Massager N (2007) Internal carotid occlusion following gamma knife radiosurgery for cavernous sinus meningioma. Stereotact Funct Neurosurg 85:303–306CrossRefGoogle Scholar
  68. 68.
    Niranjan A, Gobbel GT, Kondziolka D, Flickinger JC, Lunsford LD (2004) Experimental radiobiological investigations into radiosurgery: present understanding and future directions. Neurosurgery 55:495–504 discussion 504–495CrossRefGoogle Scholar
  69. 69.
    Larson DA, Flickinger JC, Loeffler JS (1993) The radiobiology of radiosurgery. Int J Radiat Oncol Biol Phys 25:557–561CrossRefGoogle Scholar
  70. 70.
    Colombo F, Casentini L, Cavedon C, Scalchi P, Cora S, Francescon P (2009) Cyberknife radiosurgery for benign meningiomas: short-term results in 199 patients. Neurosurgery 64:A7–A13CrossRefGoogle Scholar
  71. 71.
    Conti A, Pontoriero A, Midili F, Iati G, Siragusa C, Tomasello C, La Torre D, Cardali SM, Pergolizzi S, De Renzis C (2015) CyberKnife multisession stereotactic radiosurgery and hypofractionated stereotactic radiotherapy for perioptic meningiomas: intermediate-term results and radiobiological considerations. Springerplus 4:37CrossRefGoogle Scholar
  72. 72.
    Oermann EK, Bhandari R, Chen VJ, Lebec G, Gurka M, Lei S, Chen L, Suy S, Azumi N, Berkowitz F, Kalhorn C, McGrail K, Collins BT, Jean WC, Collins SP (2013) Five fraction image-guided radiosurgery for primary and recurrent meningiomas. Front Oncol 3:213CrossRefGoogle Scholar
  73. 73.
    McTyre E, Helis CA, Farris M, Wilkins L, Sloan D, Hinson WH, Bourland JD, Dezarn WA, Munley MT, Watabe K, Xing F, Laxton AW, Tatter SB, Chan MD (2017) Emerging indications for fractionated gamma knife radiosurgery. Neurosurgery 80:210–216PubMedPubMedCentralGoogle Scholar
  74. 74.
    Messerer M, Dubourg J, Saint-Pierre G, Jouanneau E, Sindou M (2012) Percutaneous biopsy of lesions in the cavernous sinus region through the foramen ovale: diagnostic accuracy and limits in 50 patients. J Neurosurg 116:390–398CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Henri-Arthur Leroy
    • 1
    • 2
    • 3
    Email author
  • Constantin Tuleasca
    • 1
    • 4
    • 5
  • Nicolas Reyns
    • 2
  • Marc Levivier
    • 1
    • 4
  1. 1.Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife CenterCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
  2. 2.Department of Neurosurgery and Neuro-oncologyCHU LilleLilleFrance
  3. 3.Department of NeurosurgeryLille University HospitalLille CedexFrance
  4. 4.Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
  5. 5.Signal Processing Laboratory (LTS-5)Ecole Polytechnique Fédérale de LausanneLausanneSwitzerland

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