Linear accelerator radiosurgery for arteriovenous malformations.
Between May, 1988, and August, 1991, 80 patients with arteriovenous malformations (AVM's) were treated radiosurgically at the University of Florida. A mean dose of 1650 cGy was directed to the periphery of the lesion, which almost always corresponded to the 80% isodose line. The mean lesion diameter was 23 mm. Seventy-six patients were treated with one isocenter. Angiography, performed at 1 year after radiosurgery in 41 of the 48 eligible patients, revealed an overall complete thrombosis rate of 39%. The 1-year thrombosis rate was highest in those patients with relatively small AVM's. Angiography was performed at 2 years posttreatment in 21 of the 25 eligible patients, demonstrating an overall complete thrombosis rate of 81%. This incidence did not correlate with lesion size: that is, large lesions (up to 35 mm in diameter) seemed just as likely to thrombose. Two patients (2.5%) experienced hemorrhage at some time after radiosurgical treatment, and both recovered. Two patients (2.5%) have sustained mild, but permanent, radiation-induced neurological complications.
Friedman
W A
WA
Department of Neurosurgery, University of Florida, Gainesville.
Bova
F J
FJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000209:etiology; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects; D012008:Recurrence