BACKGROUND: To review our experience with morphological developments during the long-term follow-up of @entity1 treated by Gamma Knife radiosurgery for mesial @entity1315 . METHOD: Between 1995 and 1999, we treated 14 @entity1 with marginal doses of 24  Gy (n   =   6) and 18-20  Gy (n   =   8). Nine of these were operated on for insufficient @entity410 control. We reviewed @entity410 outcome and magnetic resonance images in both operated and unoperated @entity1 and also re-examined histopathology specimens. RESULTS: Of the nine operated @entity1 , two were Engel IIIA, one was @entity3480 , five were IVB, and one was Engel IVC prior to surgery. At their final visit, five cases had become Engel class IA, one @entity1 was ID, and two were IIC. In one @entity1 the follow-up was not long enough for classification. Of the five unoperated @entity1 , one was Engel class IB, one was IIIA, one IIB and one IVB at their final visit. Radionecrosis developed in 11 @entity1 , occurring more often and earlier in those treated with higher doses. Collateral @entity4 reached outside the temporal lobe in six @entity1 , caused uncal herniation in two and intracranial @entity101 in three. During longer follow-up, @entity9007 developed in 9 @entity1 , and postcontrast enhancement persisted for 2.5-16  years after GKRS in all 14 @entity1 . In five of them we detected its progression between 2 and 16  years after treatment. Signs of neoangiogenesis were found in two @entity1 and microbleeds could be seen in five. Histopathology revealed blood vessel proliferation and macrophage infiltration. CONCLUSIONS: Early delayed complications and morphological signs suggesting a risk of development of late delayed complications are frequent after radiosurgery for mesial @entity1315 . Together with its unproven antiseizure efficacy, these issues should be taken into account when planning future studies of this method.

Morphological changes after radiosurgery for mesial XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizure'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity3480 :: ('MESH:C538167', 'Disease') :: ['IVA'] @entity4 :: ('MESH:D004487', 'Disease') :: ['edema'] @entity1315 :: ('MESH:D004833', 'Disease') :: ['temporal lobe epilepsy'] @entity9007 :: ('MESH:D010192', 'Disease') :: ['postnecrotic pseudocysts']
@entity1315 :: (MESH:D004833,Disease) :: ['temporal lobe epilepsy']
