Document Detail

Hemorrhage risks and obliteration rates of arteriovenous malformations after gamma knife radiosurgery.
MedLine Citation:
PMID:  12507079     Owner:  NLM     Status:  MEDLINE    
OBJECT: The purpose of this study was to analyze the risk of hemorrhage and the obliteration rate after treatment of patients with arteriovenous malformations (AVMs). METHODS: Between 1991 and 1995, 115 patients were treated using gamma knife radiosurgery (GKS). Surgical planning was based on angiograms and three-dimensional images. The angiographic features of the AVMs and the risk factors for hemorrhage were then evaluated. Hemorrhages occurred in eight patients (7%) 7 to 42 months after GKS. Based on AVM morphology, the rates of hemorrhage were five (7.6%) of 66 for AVMs with a single draining vein, seven (14%) of 66 for AVMs with deep drainage, four (26.7%) of 15 for AVMs with a varix, four (28.6%) of 14 for AVMs with venous obstruction, eight (17.0%) of 47 for high-flow (shunt- and mixed-type) AVMs, and five (35.7%) of 14 for large AVMs with a volume of more than 10 cm3. No hemorrhages were observed in association with low-flow (moyamoya-type) AVMs in this series. Total AVM obliteration was achieved in 81.3% of 80 patients who underwent angiography. The obliteration rate was 91.3% for moyamoyatype AVMs and 67.6% for shunt- and mixed-type AVMs. Early obliteration within 12 months was achieved in 63% of the moyamoya-type AVMs. CONCLUSIONS: Moyamoya-type AVMs seem to be at risk for post-GKS hemorrhage. Intravascular embolization should be considered prior to GKS for mixed- and shunt-type AVMs in an attempt to reduce the hemodynamic stress and thereby decrease the risk of hemorrhage.
Hiroshi K Inoue; Chihiro Ohye
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  97     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-31     Completed Date:  2003-01-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  474-6     Citation Subset:  AIM; IM    
Restorative Neurosurgery, Institute of Neural Organization and Gamma Knife Center, Hidaka Hospital, Fujioka, Japan.
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MeSH Terms
Intracranial Arteriovenous Malformations / epidemiology*,  surgery*
Intracranial Hemorrhages / epidemiology*
Middle Aged
Postoperative Complications / epidemiology*
Risk Factors
Treatment Outcome

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