Document Detail


Is repeated radiosurgery an alternative to staged radiosurgery for very large brain arteriovenous malformations?
MedLine Citation:
PMID:  17937217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The results of a novel radiosurgical approach to treat large arteriovenous malformations (AVMs) with repeated radiosurgery are presented and discussed. METHODS: The outcome was studied following repeated Gamma Knife surgery (GKS) for large AVMs, defined as a nidus volume of 9 ml or more. The philosophy was to treat the whole AVM with a low dose of radiation (> or = 10 Gy), and to repeat the treatment if the AVM shrank but was not obliterated. The study included 133 patients with AVMs treated at one of three different institutions. Clinical information was available for all patients, and complete radiological follow-up was available in 89 patients after the first treatment, and in 19 after the second treatment. RESULTS: The estimated obliteration rate following repeated GKS was 62%. Four patients (3%) developed neurological deficits caused by the radiation, whereas five others (4%) developed cystic changes. The annual incidence of hemorrhage was high (7%), of which 35% occurred within the 1st year after the first treatment. CONCLUSIONS: Repeated radiosurgery seems to be a viable option for some AVMs considered to be too large for conventional radiosurgical treatment. The incidence of posttreatment hemorrhages seems to be a larger clinical problem than radiation-induced complications.
Authors:
Bengt Karlsson; Hidefumi Jokura; Masaaki Yamamoto; Michael Söderman; Ingmar Lax
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  107     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-16     Completed Date:  2007-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  740-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, West Virginia University, Morgantown, West Virginia 26506, USA. nykuttram@yahoo.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cerebral Hemorrhage / epidemiology
Child
Child, Preschool
Disease-Free Survival
Female
Follow-Up Studies
Humans
Incidence
Intracranial Arteriovenous Malformations / epidemiology,  pathology*,  surgery*
Male
Middle Aged
Postoperative Complications / epidemiology
Radiation Dosage
Radiosurgery / methods*,  statistics & numerical data
Reoperation / methods*,  statistics & numerical data
Risk Factors
Treatment Outcome

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


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