| Aneurysms Increase the Risk of Rebleeding After Stereotactic Radiosurgery for Hemorrhagic Arteriovenous Malformations. | |
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MedLine Citation:
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PMID: 22879101 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The purpose of this study was to define the risk of rebleeding after stereotactic radiosurgery (SRS) for hemorrhagic arteriovenous malformations with or without associated intracranial aneurysms. METHODS: Between 1987 and 2006, we performed Gamma Knife SRS on 996 patients with brain arteriovenous malformations; 407 patients had sustained an arteriovenous malformation hemorrhage. Sixty-four patients (16%) underwent prior embolization and 84 (21%) underwent prior surgical resection. The median target volume was 2.3 mL (range, 0.1-20.7 mL). The median margin dose was 20 Gy (range, 13.5-27 Gy). RESULTS: The overall rate of total obliteration defined by angiography or MRI was 56%, 77%, 80%, and 82% at 3, 4, 5, and 10 years, respectively. Before obliteration, 33 patients (8%) sustained an additional hemorrhage after SRS. The overall annual hemorrhage rate until obliteration after SRS was 1.3%. The presence of a patent aneurysm was significantly associated with an increased rehemorrhage risk after SRS (annual hemorrhage rate, 6.4%) compared with patients with a clipped or embolized aneurysm (annual hemorrhage rate, 0.8%; P=0.033). CONCLUSIONS: When an aneurysm is identified in patients with arteriovenous malformations selected for SRS, additional endovascular or surgical strategies should be considered to reduce the risk of bleeding during the latency interval. |
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Authors:
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Hideyuki Kano; Douglas Kondziolka; John C Flickinger; Huai-Che Yang; Kyung-Jae Park; Thomas J Flannery; Xiaomin Liu; Ajay Niranjan; L Dade Lunsford |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-8-9 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: - ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-8-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Departments of Neurological Surgery, Radiation Oncology, and the Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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