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Repeat Radiosurgery Treatment After Cavernous Malformation Radiosurgery.

Gábor Nagy1, John Yianni2, Debapriya Bhattacharyya2

  • 1National Institute of Clinical Neurosciences, Budapest, Hungary.

World Neurosurgery
|July 4, 2018
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Summary
This summary is machine-generated.

Repeat radiosurgery (RS) for cavernous malformations (CMs) is safe, with no reported bleeds or mortality. This pilot study suggests second RS may be effective for previously treated CMs.

Keywords:
Basal gangliaBrainstemCavernous malformationHemisphericRadiosurgeryRetreatmentThalamus

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Vascular Neurology

Background:

  • Cavernous malformations (CMs) treated with radiosurgery (RS) have a 5% re-bleeding rate after a 2-year latency period.
  • This failure rate is comparable to other pathologies requiring repeat RS.
  • Defining failure and assessing the safety of repeat RS for CMs is crucial.

Purpose of the Study:

  • To define failure in CMs treated with RS.
  • To evaluate the safety and potential efficacy of a second RS procedure for previously treated CMs.

Main Methods:

  • Retrospective analysis of 7 patients with CMs who underwent repeat RS.
  • Median time between treatments was 8 years; median follow-up after second RS was 3 years.
  • Analysis included CM location, treatment parameters, and outcomes.

Main Results:

  • No bleeds, morbidity, or mortality occurred after second RS.
  • Transient neurologic deficits occurred in 2-6% of cases post-RS, without hemorrhage.
  • Failure was attributed to inaccurate target definition in only 2 cases.

Conclusions:

  • Second RS for previously treated CMs appears to be safe.
  • Repeat RS may be an effective treatment option for CMs.
  • Further research is needed to confirm long-term benefits.