MATERIAL and METHODS: A total of 10 CSH patients were treated with GKRS using a median margin dose of 14.2Gy (range 13–16Gy). The median follow-up period was 42 months (range 12–85 months). Tumor volumes were calculated from magnetic resonance images before treatment and compared with those after treatment.

RESULTS: Prior to the treatment, all patients complained of headache and retro-orbital pain, and six patients complained of diplopia due to abducens nerve paralysis. Within six months of treatment, all patients declared some improvement in headache and retro-orbital pain, and abducens nerve paralysis recovered fully in all six patients. At the first-year follow-up, at least 74% decrease in tumor volume was noted with average tumor volume reduction of 90.2% in all treated patients. Tumors less than 6 cm3 in volume nearly disappeared at 24 months. No tumor progression, re-growth, or radiation-induced adverse effects were noted in our patients.

CONCLUSION: Characteristic radiological features that enable identification of CSH avert the need for an open biopsy for diagnosis. Under suitable circumstances, GKRS may be considered as the primary and only therapy for CSH. GKRS has favorable outcomes in the treatment of CSH, demonstrating good tumor shrinkage, symptom recovery, and low incidence of side effects. Keywords : Stereotactic radiosurgery, Gamma Knife, Cavernous sinus hemangiomas