硬膜動静脈奇形に対する放射線療法 : 特にその遠隔成績と本法の有用性について

概要

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Treatment of dural arteriovenous malformation (DAVM) has not yet been established. Since 1976, the authors have performed radiation therapy on 12 DAVM cases, consisting of 5 in the caver-nous portion and 7 in the posterior fossa area. Extraaxial irradiation of ^<60>Co, 100-200 rad, 2-3 times per week was focused on the nidus of DAVM and on the angiomatous abnormal vascular net-work. Total doses of ^<60>Co irradiation ranged from 1,000 to 10,000 rad, with a mean value of 4,700 rad. In 11 cases out of 12, DAVM disappeared completely, as proved by angiography. The other case refused angiography and the disappearance of DAVM could not be proved. Outcome was good compared to untreated cases or cases treated by other methods. Complete disappearance of DAVM began 1 to 14 months after irradiation. The post-irradiational observation period was from 16 mon-ths to 6 years 10 months. Side effects such as radiation necrosis, occlusion of the main arterial trunk, occlusion of the venous sinus, visual or optic nerve disturbance, and appearance of meningioma did not occur in this series. Radiation therapy was considered to be effective and to produce minimal adverse effects. It should be considered the first choice in the treatment of DAVM.
日本脳神経外科学会の論文
1984-08-15