| Intracranial arteriovenous malformations treated with linear accelerator-based conformal radiosurgery: clinical outcome and prediction of obliteration. | |
MedLine Citation:
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PMID: 17445612 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Little is written about the clinical outcome and predictor factors of obliteration and treatment success in patients with intracranial AVMs treated with LINAC-based conformal radiosurgery in Mexican institutions. METHODS: We analyzed 40 patients with intracranial AVMs with a mean follow-up of 29 (range, 23-34) months. Seven AVMs (17.5%) had a volume <1 cm(3); 10 (25%), 1 to 4 cm(3); 13 (32.5%), 4.1 to 10 cm(3); and 10 (25%), >10 cm(3). The mean prescription dose was 15.4 Gy. Twenty-six patients (68%) presented hemorrhage before treatment; 4 (10%), chronic headache; 14 (35%), seizures; and 3(8%), neurologic deficit. RESULTS: Seven patients (17.5%) underwent objective clinical improvement. Thirty patients (75%) remained without clinical changes. Three patients (7.5%) developed edema and 1 (2.5%) had a rebleeding after treatment. Twenty-five patients (63%) presented complete obliteration of the AVM. A successful treatment (obliteration without a new deficit) was obtained in 23 (58%) of the cases. The percentage of obliteration was in <1 cm(3) (86%), 1 to 4 cm(3) (80%), 4.1 to 10 cm(3) (54%), and >10 cm(3) (40%), without a significant difference between groups (P = .1). Patients with RBAS of <or=1.9 had an obliteration of 79% and, those with >1.9, 48%; the successful treatment in the former resulted in 79% and, in the latter, 38% (P = .08 and P = .02, respectively). CONCLUSIONS: The clinical outcome was similar to other series. The RBAS seems to be a good predictor of obliteration and successful treatment in patients with AVMs treated with LINAC-based conformal radiosurgery. |
Authors:
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Sergio Moreno-Jiménez; Miguel Angel Celis; José Manuel Lárraga-Gutiérrez; José de Jesús Suárez-Campos; Amanda García-Garduño; Mariana Hernández-Bojórquez |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgical neurology Volume: 67 ISSN: 0090-3019 ISO Abbreviation: Surg Neurol Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-20 Completed Date: 2007-07-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0367070 Medline TA: Surg Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 487-91; discussion 491-2 Citation Subset: IM |
Affiliation:
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Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico City, C.P. 14269, México DF. ser_radioneurocirugia@yahoo.com.mx <ser_radioneurocirugia@yahoo.com.mx> |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Brain Edema / epidemiology, physiopathology Cerebral Arteries / abnormalities*, physiopathology, surgery* Child Female Headache / etiology Humans Intracranial Arteriovenous Malformations / pathology, physiopathology, surgery* Male Middle Aged Postoperative Complications / epidemiology*, physiopathology Postoperative Hemorrhage / epidemiology, physiopathology Radiation Dosage Radiosurgery / standards, statistics & numerical data*, trends* Recurrence / prevention & control Seizures / etiology Treatment Outcome |
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