أعضاء هيئة التدريس - جامعة بنها
Volume-staged gamma knife radiosurgery for large brain arteriovenous malformations.
World Neurosurgery • 2019
معلومات البحث
المؤلفون
El-Shehaby AMN1, Reda WA2, Abdel Karim KM3, Emad Eldin RM4, Nabeel AM5, Tawadros SR2.
الكلمات المفتاحية
arteriovenous malformation; gamma knife; single-session; staged
المجلة العلمية
World Neurosurgery
الناشر
Not Available
المجلد
Not Available
العدد
Not Available
الصفحات
Not Available
publication.type
International
رابط البحث
Not Available
المواد المرفقة
Not Available
الملخص
Abstract
OBJECTIVE:
Large brain arteriovenous malformations (AVM) pose a management dilemma because of the limited success of any single treatment modality by itself. Surgery alone is associated with significant morbidity and mortality. Similarly, embolization alone has limited efficacy. Volume-staged gamma knife radiosurgery (VSGR) has been developed for the treatment of large AVMs, to increase the efficacy and improve safety of treatment of these lesions. The aim of the study was to assess the efficacy and safety of VSGR technique for the treatment of large brain AVMs.
METHODS:
The study included patients treated by VSGR between May 2009 and July 2015. All cases had large AVMs (>10 ml). These were 29 patients.
RESULTS:
Twenty-four patients completed radiographic follow up with 15 obliteration cases (62.5%). There was a total of 56 sessions performed. The mean AVM volume was 16 ml (10.1-29.3 ml). The mean prescription dose was 18 Gy (14-22 Gy). The mean follow up duration was 43 months (21-73 months). One patient died during follow up from unrelated cause. Two cases suffered haemorrhage during follow up. Symptomatic edema developed in 5 (17%) patients. The factors affecting obliteration were smaller total volume, higher dose/stage, non-deep location, compact AVM, AVM score less than 3, >18 Gy dose and
OBJECTIVE:
Large brain arteriovenous malformations (AVM) pose a management dilemma because of the limited success of any single treatment modality by itself. Surgery alone is associated with significant morbidity and mortality. Similarly, embolization alone has limited efficacy. Volume-staged gamma knife radiosurgery (VSGR) has been developed for the treatment of large AVMs, to increase the efficacy and improve safety of treatment of these lesions. The aim of the study was to assess the efficacy and safety of VSGR technique for the treatment of large brain AVMs.
METHODS:
The study included patients treated by VSGR between May 2009 and July 2015. All cases had large AVMs (>10 ml). These were 29 patients.
RESULTS:
Twenty-four patients completed radiographic follow up with 15 obliteration cases (62.5%). There was a total of 56 sessions performed. The mean AVM volume was 16 ml (10.1-29.3 ml). The mean prescription dose was 18 Gy (14-22 Gy). The mean follow up duration was 43 months (21-73 months). One patient died during follow up from unrelated cause. Two cases suffered haemorrhage during follow up. Symptomatic edema developed in 5 (17%) patients. The factors affecting obliteration were smaller total volume, higher dose/stage, non-deep location, compact AVM, AVM score less than 3, >18 Gy dose and