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Radiosurgery for vascular malformations of the brain stem
C M Duma1, L D Lunsford, D Kondziolka
1Department of Neurosurgery, University of Pittsburgh Medical Center, PA.
Acta Neurochirurgica. Supplementum
|January 1, 1993
Summary
Radiosurgery effectively treats brain stem vascular malformations, including arteriovenous malformations (AVMs) and angiographically occult vascular malformations (AOVMs). This technique offers a safe alternative to microsurgery, with high obliteration rates and no rehemorrhage in AOVMs post-treatment.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Vascular Neurology
Background:
- Microsurgery for brain stem vascular malformations presents significant challenges.
- Alternative therapeutic strategies are crucial for managing these complex lesions.
Purpose of the Study:
- To evaluate the efficacy and safety of radiosurgery for brain stem vascular malformations.
- To review a 5-year experience with gamma unit radiosurgery in 50 patients.
Main Methods:
- Retrospective review of 50 patients treated with gamma knife radiosurgery.
- Patients included symptomatic arteriovenous malformations (AVMs) and angiographically occult vascular malformations (AOVMs).
- Follow-up included clinical evaluation, MRI, and angiography.
Main Results:
- 88% obliteration rate for AVMs with available 2-year angiograms.
- No rehemorrhage observed in AOVM patients after 15 months post-radiosurgery.
- Radiosurgery demonstrated safety and efficacy in managing challenging brain stem lesions.
Conclusions:
- Gamma knife radiosurgery is an effective and safe treatment for brain stem vascular malformations.
- It serves as a viable alternative to microsurgery, particularly for inoperable cases.
- Long-term follow-up confirms sustained positive outcomes.