title: Gamma knife radiosurgery of brain cavernomas.
abstract: OBJECTIVE
  Radiosurgery of cavernomas should prevent rebleeding, growth of the lesion, and deterioration of clinical symptoms. However, there is no direct diagnostic tool to verify the endpoints of treatment. At present, the positive effects of radiosurgery are identified by clinical observation and analysis of imaging changes on magnetic resonance imaging during a sufficiently long follow-up period.
  
  
  METHODS
  Between 1992 and 2000, a total of 112 patients with brain cavernomas were treated with Gamma Knife radiosurgery at our center. In all, 59 patients experienced bleeding before radiosurgery; the remainder did not. The median age of patients was 42 years, the median volume of the cavernomas was 0.9 cm(3), and the median applied marginal dose was 16 Gy.
  
  
  RESULTS
  After a 2-year latent interval after treatment (median follow-up 84 months), the risk of bleeding in the group of patients with bleeding before radiosurgery had decreased from 3.7 % to 0.2 %. For the patients without bleeding before radiosurgery, the annual risk of bleeding was 0.8 %. The cavernoma size decreased in 53.0 % of cases and increased in 6.4 %. Epilepsy, if present before the treatment, was alleviated in 45 % of cases. The risks of temporary or permanent morbidity caused by radiosurgery were 14.6 % and 0.9 %, respectively.
  
  
  CONCLUSIONS
  Radiosurgery of cavernomas was associated with a low risk of permanent morbidity. The risk of rebleeding after the 2-year latent interval after radiosurgery had decreased. Treatment of cavernomas with no history of bleeding was halted at our center.
authors: Hospital Na Homolce, Roentgenova 2, Prague, 150 30, Czech Republic. roman.liscak@homolka.cz
authors: Roman
authors: R
authors: Liscak
authors: Dusan
authors: D
authors: Urgosik
authors: Gabriela
authors: G
authors: Simonova
authors: Josef
authors: J
authors: Vymazal
authors: Jitka
authors: J
authors: Semnicka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006392:Hemangioma, Cavernous / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult