Cognitive function in patients with cerebral arteriovenous malformations after radiosurgery: prospective long-term follow-up.
OBJECTIVE
To evaluate the long-term cognitive function of patients with cerebral arteriovenous malformations (AVMs) after radiosurgery.


METHODS
The data of 95 AVM patients were prospectively assessed up to 3 years after radiosurgery. Of these patients, 39 had a follow-up of at least 2 years. Radiosurgery was performed using a modified linear accelerator (minimal doses to the target volume 15-22 Gy, median dose 20). The neuropsychological evaluation included testing of intelligence, attention, and memory. The effect of a preexisting intracranial hemorrhage, as well as AVM occlusion, on cognitive functions was analyzed after 1 and 2 years.


RESULTS
No cognitive declines were observed during follow-up. Instead significant improvements occurred in intelligence (1 year, +6.1 IQ points; 2 years, +5.1 IQ points), memory (1 year, +18.3 percentile score; 2 years, +12.2 percentile score), and attention (1 year, +19 percentile score; 2 years, +18 percentile score). Patients without previous intracranial hemorrhage improved more than patients with intracranial hemorrhage, although this difference was not statistically significant. The role of AVM occlusion on cognitive function is not clear at present.


CONCLUSIONS
Radiosurgery does not induce measurable deterioration of cognitive function in patients with cerebral AVMs.
Steinvorth
Sarah
S
Department of Neurology, University of Heidelberg, Heidelberg, Germany.
Wenz
Frederik
F
Wildermuth
Susanne
S
Essig
Marco
M
Fuss
Martin
M
Lohr
Frank
F
Debus
Jürgen
J
Wannenmacher
Michael
M
Hacke
Werner
W
D000328:Adult; D003071:Cognition / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010315:Particle Accelerators; D016634:Radiosurgery / Q000009:adverse effects*; D013997:Time Factors