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For hemangioblastomas, Von Hippel Lindau disease, Lindau's disease, cystic hemangioblastomas, recurrent hemangioblastomas, hemangioblastomas radiosurgery and cerebellar hemangioblastomas please visit our site.

Email Dr. Jeffery Williams (jw@jhu.edu). The decisions related to treatment for the hemangioblastomas inclucing cerebellar hemangioblastomas and cystic hemangioblastomas depend upon the complete understanding of the competing risks vs. benefits for the different treatments. Options for hemangioblastoma treatment may include surgery or radiosurgery. The FSR (fractionated stereotactic radiosurgery) for hemangioblastomas is an important option for treatment. The important considerations include the size and rate of growth of the hemangioblastoma as well as the progression of any symptoms.

Click Here for Dr. Williams C.V. Curriculum Vitae: Dr. Jeffery Williams
Director, Brain Tumor Radiosurgery
The Johns Hopkins Hospital
Board Certified: Neurological Surgery
Board Certified: Radiation Oncology
Email jw@jhu.edu Dr. Jeffery Williams.

Email Address: jw@jhu.edu
Phone: 410-614-2886
Fax: 410-614-2982


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Hemangioblastoma Treatments

  • Hemangioblastomas Treatments: Hemangioblastomas are seen most often in the cerebellum but may also occur in the retina, brain stem, cerebral meninges and spinal cord. The minority of hemangioblastomas are associated with von Hippel-Lindau disease in which multiple lesions are usually seen.

  • Less than 10 percent of hemangioblastomas are associated with polycythemia. The hemangioblastomas usually occur in adults. The hemangioblastomas in the cerebellum and spinal cord are often associated with a cyst whose wall is formed of glial cells.

  • The decisions related to treatment of hemangioblastomas depend upon the complete understanding of the risks and benefits of the competing methods for treatment.


Hemangioblastomas Radiosurgery Discussion




Hemangioblastomas Topics




Hemangioblastomas

Hemangioblastomas cause specific clinical syndromes.

Hemangioblastomas are a diverse group of brain tumors. Hemangioblastomas arise from the normal "glial" cells of the brain. These cells outnumber the "neurons" that conduct impulses and serve to provide metabolic support to the neurons. The Hemangioblastomas have specific signs and symptoms that are primarily related to the location of the Hemangioblastoma .

  • The cerebellar Hemangioblastomas, for example may cause difficulty with gait (ataxia), co-ordination or nystagmus (oscillation of the eyes on lateral gaze toward the side of the tumor). Larger tumors may cause hydrocephalus. On occasion the polycythemia caused by the hemangioblastoma may result in deep venous thrombosis or other vascular abnormality.

  • The temporal lobe Hemangioblastomas, for example may cause epilepsy, difficulty with speech or loss of memory.

  • The frontal lobe Hemangioblastomas may cause behavioral changes, weakness of the arms or legs or difficulty with speech.

  • The occipital Hemangioblastomas may cause loss of vision.

  • The parietal Hemangioblastomas may cause loss of spatial orientation, diminished sensation on the opposite side of the body, or inability to recognize once familiar objects or persons.
Microsurgical resection of Hemangioblastomas can be performed.

Microsurgical resection of Hemangioblastomas can be done via several approaches.

  • The craniotomy involves opening the skull, opening the covering of the brain (the dura) and exposing the tumor.

  • Once the tumor is exposed it is carefully resected.

Stereotactic Radiosurgery offers non-invasive treatment of certain newly diagnosed or recurrent Hemangioblastomas.

Stereotactic Radiosurgery allows specific irradiation of the tumor. Narrow beams of radiation specifically target only the tumor. The normal brain is spared and does not receive significant exposure.

  • Stereotactic radiosurgery may be particularly suitable for Hemangioblastomas.

  • For recurrent Hemangioblastomas after conventional surgery and radiation, stereotactic radiosurgery is an option for treatment.

  • The most important aspect of the Hemangioblastoma suitable for radiosurgery is the size. Smaller tumors are treated more effectively by the radiosurgery.

The patient information may be submitted.

Stereotactic Radiosurgery offers specific, local treatment to the Hemangioblastoma with sparing of surrounding normal tissues. The forms below allow the important information to be sent. This information can help in the discussion of the most appropriate treatment. The treatment decisions for the Hemangioblastomas are complex. Much depends upon the age and "performance status" of the patient.





Hemangioblastoma Radiosurgery

The form below may be of interest to patients who have Hemangioblastomas. It outlines many of the important questions related to this clinical entity. If desired, the form can be sent to Dr. Williams using the "Send Form" button at the end of the page. Dr. Williams can, if desired, subsequently correspond regarding the issues related to the treatment options.

The tumors most amenable to radiosurgical treatment are:

  • Small in size (usually less than 3 centimeters in diameter).

  • Deep location rendering resection difficult or hazardous.

  • Well demarcated on MRI.

Prior Treatments:
  • Many patients undergo a series of treatments for the Hemangioblastomas including multiple surgical resections, conventional external beam radiotherapy and possibly systemic chemotherapy.

  • Radiosurgery is a consideration even in the context of intense prior treatments. This is because the radiosurgery limits dose to the tumor, sparing normal brain. Further, the fractionation of the treatment further spares normal brain.

Hemangioblastoma Discussion

Email Dr. Williams regarding Hemangioblastoma treatment options: Dr. Williams

Your email address (if response is desired):


Please enter the responses and click on the "Submit Form" button at the end of this form.

Initial Hemangioblastoma Diagnosis


  • Date of Diagnosis

    What is the DATE of the diagnosis of the first Hemangioblastoma (If a Hemangioblastoma was diagnosed in the past before the current Hemangioblastoma )?







  • Method of Diagnosis of Hemangioblastoma

    How was the first Hemangioblastoma diagnosed?

    Stereotactic Biopsy

    Craniotomy

    Only radiographically




  • Location of Hemangioblastoma

    What was the location of the Hemangioblastoma ? (Please ask your doctor for clarification of the location.)

    Supratentorial (Above tentorium)

    Posterior Fossa (Cerebellar)

    Other




  • Number of Tumors

    How many Hemangioblastomas were there initially prior to any treatment, right after the first diagnosis?

    One (solitary)

    Two

    Three

    Four

    Five

    More than Five




  • First treatment(s) prior to current treatment (if applicable)

    How was the first Hemangioblastoma treated?

    Stereotactic Biopsy only

    Craniotomy only

    Stereotactic Biopsy and Radiation

    Craniotomy and Radiation

    Craniotomy or biopsy, radiation and chemotherapy




  • Date of initial treatment after first diagnosis (if applicable)

    What was the DATE of the treatment for the FIRST Hemangioblastoma ?






Current Hemangioblastoma


  • What is the DATE of the DIAGNOSIS of the CURRENT Hemangioblastoma (or Hemangioblastomas if more than one)? (This (these) Hemangioblastoma (s) are for consideration for the CURRENT radiosurgery or surgical resection).




  • Number of Tumors now

    How many Hemangioblastomas are there now?
    One (solitary)

    Two

    Three

    Four

    Five

    More than Five




  • Size of tumor now

    What is the largest dimension (in centimeters) of the Hemangioblastoma (or largest Hemangioblastoma if more than one)? One

    Two Centimeters

    Three Centimeters

    Four Centimeters

    Five Centimeters

    More than Five Centimeters




  • Current Treatment other than Radiosurgery

    Prior to Radiosurgery (if applicable), how is the CURRENT Hemangioblastoma (or group of Hemangioblastoma s) treated?

    Stereotactic Biopsy only

    Craniotomy and removal of as much tumor as possible

    Craniotomy and external beam irradiation (regular radiation)

    Craniotomy and external beam irradiation (regular radiation)and chemotherapy.

    Other (not listed above):





This completes the Hemangioblastoma Registration Page.

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