Stereotactic radiosurgery and the risk of haemorrhage from cavernous malformations.
Eighteen patients with cerebral cavernous malformations were treated with single dose of cobalt 60 source stereotactic radiosurgery. All had suffered at least one haemorrhage prior to treatment with six suffering 2, four suffering 3 and one suffering 4. Mean follow-up was 4.5 years. A total of 36 pretreatment haemorrhages occurred in 139 patient years. The first haemorrhage each patient suffered was taken as the start of observation and not included in the rehaemorrhage rate calculation. Three posttreatment haemorrhages occurred in 81 patient years of observation. The annual haemorrhage rate thus fell from 13% before to 3.7% after treatment. The odds ratio was thus 0.29 with a 95% confidence interval of (0.08-0.97), but this must be interpreted with caution because of the prereferral selection of this group of patients. Three patients developed complications of radiosurgery, two of them recovered fully.
Mitchell
P
P
Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK.
Hodgson
T J
TJ
Seaman
S
S
Kemeny
A A
AA
Forster
D M
DM
D000293:Adolescent; D000328:Adult; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016012:Poisson Distribution; D016634:Radiosurgery / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012008:Recurrence; D012306:Risk; D016896:Treatment Outcome