title: Gamma Knife Radiosurgery for Pediatric Arteriovenous Malformations: A Canadian Experience.
abstract: BACKGROUND
  Gamma Knife (GK) radiosurgery for pediatric arteriovenous malformations (AVM) of the brain presents a non-invasive treatment option. We report our institutional experience with GK for pediatric AVMs.
  
  
  METHODS
  We performed a retrospective review of all pediatric patients treated with GK for cerebral AVMs at our institution from November 2003 up to and including September 2014. Patient demographics, AVM characteristics, treatment parameters and AVM responses were recorded.
  
  
  RESULTS
  Nineteen patients were treated, with 4 lost to follow-up. The mean age was 14.2 years (range. 7-18 years), with 10 being males (52.6%). The mean AVM diameter and volume were 2.68 cm and 3.10 cm3 respectively. The mean Spetzler-Martin (SM) and Pollock grades of the treated AVMs were 2.4 and 0.99 respectively. The mean follow-up was 62 months. All AVMs treated demonstrated a response on follow-up imaging. Nine of 15 (60.0%) patients displayed obliteration of their AVMs. Nine of 11 patients with a minimum of 3 years follow-up (81.8%) displayed obliteration, with SM and Pollock grades correlating to the chance of obliteration in this group. Two patients developed post-GK edema requiring short course dexamethasone therapy. No other major complications occurred. No permanent complications occurred.
  
  
  CONCLUSIONS
  GK radiosurgery for pediatric AVMs offers a safe and effective treatment option, with low permanent complication rates during early follow-up.
authors: 1Section of Neurosurgery,Medical University of Warsaw,Warsaw,Poland.
authors: Fred A
authors: FA
authors: Zeiler
authors: 2Undergraduate Medicine,Medical University of Warsaw,Warsaw,Poland.
authors: Maciej K
authors: MK
authors: Janik
authors: 1Section of Neurosurgery,Medical University of Warsaw,Warsaw,Poland.
authors: Patrick J
authors: PJ
authors: McDonald
authors: 1Section of Neurosurgery,Medical University of Warsaw,Warsaw,Poland.
authors: Anthony M
authors: AM
authors: Kaufmann
authors: 1Section of Neurosurgery,Medical University of Warsaw,Warsaw,Poland.
authors: Derek
authors: D
authors: Fewer
authors: 3Section of Radiation Oncology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Jim
authors: J
authors: Butler
authors: 3Section of Radiation Oncology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors: Garry
authors: G
authors: Schroeder
authors: 1Section of Neurosurgery,Medical University of Warsaw,Warsaw,Poland.
authors: Michael
authors: M
authors: West
mesh_terms: D000293:Adolescent; D001164:Arteriovenous Fistula / Q000601:surgery*; D002170:Canada; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
keywords: CNS malformations; Cerebrovascular disease; neurosurgery - pediatric; neurosurgery - vascular; pediatrics; radiation oncology; radiosurgery; stereotactic