Related Experiment Videos
Ultrastructural changes in arteriovenous malformations after gamma knife surgery: an electron microscopic study
György T Szeifert1, Ottó Major, Andras A Kemeny
1Department of Neurological Surgery, National Centre for Stereotactic Radiosurgery, Royal Hallamshire Hospital, Sheffield, England. gyorgyszeifert@yahoo.com
Journal of Neurosurgery
|January 25, 2005
Summary
Gamma knife surgery (GKS) on arteriovenous malformations (AVMs) induced spindle cell proliferation, resembling myofibroblasts. These cells may contribute to AVM shrinkage and occlusion post-radiosurgery.
Area of Science:
- Vascular Biology
- Neurosurgery
- Cellular Pathology
Background:
- Arteriovenous malformations (AVMs) are complex vascular anomalies.
- Gamma knife surgery (GKS) is a treatment modality for AVMs.
- Understanding cellular changes post-GKS is crucial for AVM management.
Purpose of the Study:
- To analyze subcellular morphological alterations in AVMs following GKS.
- To investigate the nature of spindle cell proliferation observed after GKS treatment.
Main Methods:
- Histological, immunohistochemical, and transmission electron microscopy were employed.
- Pathological specimens from seven patients with GKS-treated cerebral AVMs were analyzed.
- Specimens were from AVMs that had previously bled post-GKS.
Main Results:
- Spindle cell proliferation was identified in the stroma and subendothelial regions of irradiated AVM vessels.
- Electron microscopy revealed diverse ultrastructural features of these spindle cells.
- Cells exhibited characteristics similar to myofibroblasts, including collagen bundles, intracytoplasmic filaments, and endoplasmic reticulum development.
Conclusions:
- The spindle cell population in GKS-treated AVMs shares similarities with myofibroblasts found in wound healing and fibromatoses.
- These myofibroblast-like cells were not observed in non-irradiated AVM controls.
- Myofibroblasts are implicated in the AVM shrinking and occlusion process after radiosurgery.