title: Long-term control of large pontine arteriovenous malformation using gamma knife therapy: a review with illustrative case.
abstract: Brain stem arteriovenous malformations (AVMs) are rare and their clinical management is controversial. A location in highly eloquent areas and a greater risk of radionecrosis are both serious issues for radiosurgery of this entity. We report a case of a pontine AVM treated successfully with gamma knife therapy. At 3 years angiographic follow-up, imaging demonstrated complete thrombosis and there were no new neurological deficits, and at 7 years clinical follow-up, the patient continued to be neurologically stable. Although all treatments carry risk of neurological compromise, gamma knife therapy may offer the best treatment option for brain stem AVMs as seen in the case presented herein. This case illustrates a rare case of holo-pontine AVM tolerating gamma radiation with complete angiographical response and minimal neurological sequalae.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Alabama at Birmingham Birmingham, Alabama.
authors.forename: Martin M
authors.initials: MM
authors.lastname: Mortazavi
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Alabama at Birmingham Birmingham, Alabama.
authors.forename: Daxa
authors.initials: D
authors.lastname: Patel
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Alabama at Birmingham Birmingham, Alabama.
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Griessenauer
authors.affiliation: Pediatric Neurosurgery, Children's Hospital Birmingham, Alabama.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Alabama at Birmingham Birmingham, Alabama.
authors.forename: Winfield S
authors.initials: WS
authors.lastname: Fisher
keywords: Arteriovenous malformation; brain stem