title: Cognitive function in patients with cerebral arteriovenous malformations after radiosurgery: prospective long-term follow-up.
abstract: 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.
authors.affiliation: Department of Neurology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Steinvorth
authors.forename: Frederik
authors.initials: F
authors.lastname: Wenz
authors.forename: Susanne
authors.initials: S
authors.lastname: Wildermuth
authors.forename: Marco
authors.initials: M
authors.lastname: Essig
authors.forename: Martin
authors.initials: M
authors.lastname: Fuss
authors.forename: Frank
authors.initials: F
authors.lastname: Lohr
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Michael
authors.initials: M
authors.lastname: Wannenmacher
authors.forename: Werner
authors.initials: W
authors.lastname: Hacke
mesh_terms: 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