Long-Term Outcomes of Gamma Knife Surgery for Posterior Fossa Arteriovenous Malformations
スポンサーリンク
概要
- 論文の詳細を見る
The long-term outcomes of gamma knife surgery (GKS) in patients with posterior fossa arteriovenous malformations (AVMs) were retrospectively analyzed in 82 patients followed up for more than 5 years to evaluate the efficacy and safety. The median AVM volume at GKS was 0.95 cm3. The prescribed dose to the AVM margin was median 18 Gy with 1–18 isocenters. The actual complete AVM obliteration rate was 58.5% at 3 years and 78.0% at 5 years. The significant factors for higher complete obliteration rate were younger patient age and smaller maximum/minimum nidus diameter ratio. Two patients experienced hemorrhage caused by residual AVM rupture at 4 and 49 months. Twenty patients developed peri-nidal edema as an adverse radiation-induced reaction at median 13 months. One patient developed radiationinduced necrosis at 6.8 years. Neurological complication was observed in 12 patients and 6 patients remained with neurological dysfunction permanently. Larger nidus volume and location adjacent to an eloquent area significantly increased the risk of neurological complication. Pittsburgh radiosurgery-based AVM grading scale was significantly correlated with the outcome of neurological symptoms after GKS. GKS achieved acceptable and complete obliteration rate for posterior fossa AVM with relatively low risk of morbidity on neuroimaging and neurological symptoms for the long-term period after treatment. We recommend conformable and selective treatment planning to achieve both obliteration of the AVM nidus and preservation of neurological function.
- 一般社団法人 日本脳神経外科学会の論文
一般社団法人 日本脳神経外科学会 | 論文
- Reply
- Impact of Bilateral Subthalamic Stimulation on Motor/Cognitive Functions in Parkinson's Disease
- Risk Factors Associated with Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage
- Isolated Pituitary Tuberculoma
- Treatment of Acute Cerebral Artery Occlusion Using the Penumbra System: Our Early Experience