title: Cavernomas: Outcomes after gamma-knife radiosurgery in Iran.
abstract: BACKGROUND
  Treatment of cavernomas remains a challenge in surgically inaccessible regions. The purpose of this study was to evaluate outcomes after gamma-knife surgery (GKS) for these patients.
  
  
  METHODS
  A retrospective review of 100 patients treated between 2003 and 2011 was conducted in order to evaluate hemorrhage rates, complications, radiation effects after GKS. Dosage at the tumor margin was stratified into two groups: those that received ≤13 Gy; and those who received >13 Gy. The demographic and clinical characteristics of patients including age, gender, and hemorrhage rates were extracted from care records.
  
  
  RESULTS
  The median age was 32.5 years (ranging from 15 to 79). 44% were female. The median follow-up time was 42.2 months (ranging from 24 to 90). The median volume of the lesions was 1050.0 mm(3) (ranging from 112.0 to 4100.0) before GKS. A reduction of 27.5% in median size of cavernomas was achieved at the last follow-up. There was 12% treatment-related morbidity after GKS. The hemorrhage rate in the first 2 years after GKS was 4.1% and 1.9% thereafter. There was no mortality due to GKS, and 93 patients were alive at the last follow-up. The radiation-related complication developed with marginal dose 13 Gy.
  
  
  CONCLUSIONS
  The GKS for cavernomas appears to be a safe and beneficial in carefully selected patients. Low-dose GKS may be effective for the management of cavernous malformations.
authors.affiliation: Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Azimi
authors.affiliation: Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Shahzadi
authors.affiliation: Department of Neurosurgery, Tehran University of Medical science, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Bitaraf
authors.affiliation: Department of Neurosurgery, Tehran University of Medical science, Tehran, Iran.
authors.forename: Maziar
authors.initials: M
authors.lastname: Azar
authors.affiliation: Department of Neurosurgery Iran Gamma-Knife Center, Tehran, Iran.
authors.forename: Mazdak
authors.initials: M
authors.lastname: Alikhani
authors.affiliation: Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Zali
authors.affiliation: Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Sadeghi
keywords: Cavernomas; Iran; gamma-knife radiosurgery; outcomes