Adverse Radiation Effects After Gamma Knife Radio Surgery and Hyperbaric Oxygen Therapy

Treatment of Adverse Radiation Effects After Gamma Knife Radiosurgery (GKS) by Hyperbaric Oxygen Therapy (HBO)

Evaluation of clinical improvement and the reduction of edema lesion documented by magnetic resonance imaging (MRI) in patients with cerebral radiation necrosis post gamma knife surgery (GKS) by treatment with hyperbaric oxygen therapy (HBO)

Patients will be recruited on the basis of the presence of cerebral radionecrosis post gamma knife surgery, documented by both clinical examination (Rankin Scale) and instrumental imaging (MRI). They will be subjected to hyperbaric oxygen therapy HBO, and during treatment the patient performs clinical examination (Rankin Scale) for 24 sessions of HBO. Then they will have a break of 10-15 days during which also performs the instrumental survey (Magnetic Resonance Imaging). If the radionecrosis has regressed they will suspend the treatment otherwise continue up to a maximum of 40 treatment sessions of HBO

Inclusion Criteria:

• between 10 and 75 years
• understanding of the Italian language
• ability to understand the procedures and carrying out of the study
• signing informed consent for adults and minors in use
• underwent radiosurgery with clinical and instrumental signs of radiation necrosis

Exclusion Criteria:

• younger than 10yrs old and older than 75yrs old
• not capable to understand Italian language or to understand the protocol procedures and visits' scheme
• informed consent not given
• enrolled in another clinical trial
• concomitant pathologies contraindicate HBO as: emphysema, asthma, epilepsy, claustrophobia; Paul Bert Syndrome, Lorrain Smith Syndrome
• under disulfiram, doxorubicine, cisplatinum, mafenide acetate, bleomycins treatment
• life expectancy less than 6 months
• Rankin Scale >5