| Gamma Knife surgery for arteriovenous malformations in children. | |
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MedLine Citation:
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PMID: 21039165 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: The aim of this study was to evaluate the long-term imaging and clinical outcomes of intracranial arteriovenous malformations (AVMs) in children treated with Gamma Knife surgery (GKS). METHODS: Between 1989 and 2007, 200 patients with AVMs who were 18 years of age or younger were treated at the University of Virginia Health System. Excluding 14 patients who had not reached 2-year follow-up, 186 patients comprised this study. Hemorrhage was the most common presenting symptom leading to the diagnosis of AVMs (71.5%). The mean nidus volume was 3.2 cm(3) at the time of GKS, and a mean prescription dose of 21.9 Gy was used. RESULTS: After initial GKS, 49.5% of patients achieved total angiographic obliteration. Forty-one patients whose AVM nidi remained patent underwent additional GKS. The obliteration rate increased to 58.6% after a second or multiple GKS. Subtotal obliteration was achieved in 9 patients (4.8%). Forty-nine patients (26.3%) still had a patent residual nidus. In 19 patients (10.2%), obliteration was confirmed on MR imaging only. Ten patients had 17 hemorrhages during the follow-up period. The hemorrhage rate was 5.4% within 2 years after GKS and 0.8% between 2 and 5 years. Six patients developed neurological deficits along with the radiation-induced changes. Two patients developed asymptomatic meningiomas 10 and 12 years after GKS. After a mean clinical follow-up of 98 months, less than 4% of patients had difficulty attending school or developing a career. CONCLUSIONS: Gamma Knife surgery offers a reasonable chance of obliteration of an AVM in pediatric patients. The incidence of symptomatic radiation-induced changes is relatively low; however, long-term clinical and imaging follow-up is required to identify delayed cyst formation and secondary tumors. |
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Authors:
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Chun Po Yen; Stephen J Monteith; James H Nguyen; Jessica Rainey; David J Schlesinger; Jason P Sheehan |
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Publication Detail:
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Type: Journal Article; Webcasts |
Journal Detail:
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Title: Journal of neurosurgery. Pediatrics Volume: 6 ISSN: 1933-0715 ISO Abbreviation: J Neurosurg Pediatr Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-02 Completed Date: 2010-11-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101463759 Medline TA: J Neurosurg Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 426-34 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Brain Damage, Chronic / etiology Cerebral Angiography Cerebral Hemorrhage / etiology Child Child, Preschool Female Follow-Up Studies Humans Intracranial Arteriovenous Malformations / diagnosis, radiography, surgery* Learning Disorders / etiology Male Meningeal Neoplasms / etiology Meningioma / etiology Postoperative Complications / etiology Radiosurgery / methods* Reoperation |
| Comments/Corrections | |
Comment In:
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J Neurosurg Pediatr. 2010 Nov;6(5):424; discussion 424-5
[PMID:
21039164
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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