Document Detail


Intracranial arteriovenous malformations treated with linear accelerator-based conformal radiosurgery: clinical outcome and prediction of obliteration.
MedLine Citation:
PMID:  17445612     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Sergio Moreno-Jiménez; Miguel Angel Celis; José Manuel Lárraga-Gutiérrez; José de Jesús Suárez-Campos; Amanda García-Garduño; Mariana Hernández-Bojórquez
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  67     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-20     Completed Date:  2007-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  487-91; discussion 491-2     Citation Subset:  IM    
Affiliation:
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:
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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