Document Detail


Gamma Knife surgery for intracranial arteriovenous malformations in children: a retrospective study in 103 patients.
MedLine Citation:
PMID:  18154017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: This retrospective study was designed to study the outcome in children with intracranial arteriovenous malformations (AVMs) treated with Gamma Knife surgery (GKS). METHODS: One hundred and forty-two children were treated with GKS at the authors' institution between April 1997 and March 2006; of these, 103 patients with a mean follow-up of 26.4 months (range 6-96 months) were included. The mean age at presentation was 13.9 years (range 3-18 years). Eighty-six (83%) patients presented with hemorrhage. In 57 children the AVMs were Spetzler-Martin Grade I or II, and in 46 the AVMs were Grades III, IV, or V. The mean volume of the AVMs was 2.4 ml (range 0.04-23.3 ml). The mean marginal dose administered was 24.4 Gy (range 15-27 Gy). Follow-up angiography was advised at 2 years after GKS and yearly thereafter. In patients with residual AVMs, follow-up angiography was advised yearly until 4 years after GKS. If residual AVM was present, even on a follow-up angiogram obtained 4 years postsurgery, the GKS was considered a failure. RESULTS: Complete obliteration of the AVM was documented in 34 (87%) of the 39 patients with complete angiographic follow-up. The 3- and 4-year actuarial rates of nidus obliteration were 66 and 86% respectively. Three patients (2.9%) experienced bleeding during the latency period, and symptomatic radiation-induced edema was noted in four patients (3.8%). A significantly higher incidence of radiation edema was noted in patients with AVM volumes greater than 3 ml and in patients with Spetzler-Martin Grade IV and V AVMs. CONCLUSIONS: Gamma Knife radiosurgery is an effective modality for the treatment of intracranial AVMs in children, yielding high obliteration rates and low complication rates.
Authors:
Narayanam Anantha Sai Kiran; Shashank Sharad Kale; Sandeep Vaishya; Manish Kumar Kasliwal; Aditya Gupta; Manish Singh Sharma; Bhavani Shankar Sharma; Ashok Kumar Mahapatra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  107     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  479-84     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Brain Edema / etiology
Cerebral Angiography
Cerebral Hemorrhage / epidemiology
Child
Child, Preschool
Embolization, Therapeutic / adverse effects
Female
Follow-Up Studies
Humans
India
Intracranial Arteriovenous Malformations / surgery*
Magnetic Resonance Imaging
Male
Radiosurgery* / adverse effects,  statistics & numerical data
Retrospective Studies
Risk Assessment
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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