title: Leksell gamma knife radiosurgery for cerebral arteriovenous malformations in pediatric patients.
abstract: OBJECTIVE
  The authors report their experience of gamma knife radiosurgery (GKR) in a large series of pediatric cerebral arteriovenous malformations (cAVMs). The advantages, risks and failures of this approach are presented and discussed.
  
  
  METHODS
  Gamma knife radiosurgery was performed on 63 children aged < or =16 years. Haemorrhage was the clinical onset in 50 out of 63 cases. The mean pre-GK cAVM volume was 3.8 cm(3). Fifty-eight out of 63 cAVMs were Spetzler-Martin grades I-III. Most lesions (47 out of 63) were in eloquent or deep-seated brain regions.
  
  
  CONCLUSIONS
  Gamma knife radiosurgery-related complications occurred in 2 out of 47 cases with an available follow-up (1 had transient and 1 permanent morbidity). No bleeding occurred during the latency period. In 39 children with >36-month follow-up, complete cAVM occlusion was angiographically documented in 31, with a 3- and 4-year actuarial obliteration rate of 72 and 77% respectively. High rates of complete obliteration and very low frequency of permanent morbidity with no bleeding during the latency period encourage widespread application of GKR in the treatment of pediatric cAVMs.
authors.affiliation: Department of Neurosurgery, University Hospital, Piazzale Stefani 1, Verona, Italy. antonio.nicolato@mail.azosp.vr.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolato
authors.forename: Roberto
authors.initials: R
authors.lastname: Foroni
authors.forename: Andrea
authors.initials: A
authors.lastname: Seghedoni
authors.forename: Valentina
authors.initials: V
authors.lastname: Martines
authors.forename: Francesco
authors.initials: F
authors.lastname: Lupidi
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Zampieri
authors.forename: Marco F
authors.initials: MF
authors.lastname: Sandri
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricci
authors.forename: Carlo
authors.initials: C
authors.lastname: Mazza
authors.forename: Alberto
authors.initials: A
authors.lastname: Beltramello
authors.forename: Massimo
authors.initials: M
authors.lastname: Gerosa
authors.forename: Albino
authors.initials: A
authors.lastname: Bricolo
mesh_terms: D000293:Adolescent; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome