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Gamma Knife for Cerebral Arteriovenous Malformations at a Single Centre

Published online by Cambridge University Press:  02 December 2014

F. A. Zeiler ,
P. J. McDonald ,
A. Kaufmann ,
D. Fewer ,
J. Butler ,
G. Schroeder  and
M. West
F. A. Zeiler*
Affiliation:
Department of Neurosurgery, Health Sciences Centre
P. J. McDonald
Affiliation:
Department of Neurosurgery, Health Sciences Centre
A. Kaufmann
Affiliation:
Department of Neurosurgery, Health Sciences Centre
D. Fewer
Affiliation:
Department of Neurosurgery, Health Sciences Centre
J. Butler
Affiliation:
Department of Radiation Oncology, CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
G. Schroeder
Affiliation:
Department of Radiation Oncology, CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
M. West
Affiliation:
Department of Neurosurgery, Health Sciences Centre
*
Department of Neurosurgery, Health Sciences Center, University of Manitoba, GB-134, 820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
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Abstract

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Background:

We report the results of a consecutive series of patients treated with Gamma Knife (GK) Surgery for cerebral arteriovenous malformations (AVMs).

Methods:

We retrospectively reviewed 69 patients treated with GK for cerebral AVMs between November 2003 and April 2009, recording clinical data, treatment parameters, and AVM obliteration rates in order to assess our effectiveness with GK in treating these lesions.

Results:

Ten patients were lost to follow-up. Presentations included: seizure (24), hemorrhage (18), persistent headache (12), progressing neurological signs (10), and incidental (9). In 24 patients (34.8%) treatment planning consisted of digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and computed tomogram (CT) angiography (CTA). Currently we rely predominantly on CTA and/or MRI scanning only. Fourty-one patients have been followed for a minimum of 3 years; average age 40.9yr., 58.5% males. Average dose at the 50% isodose line was 20.3 Gy (range 16 to 26.4 Gy). Obliteration was observed in 87.8% by MRI, CT, or DSA. Not all obliteration was confirmed by DSA. Complications occurred in 12 of 59 (20.3%) patients, and in 11 of 41 (26.8%) with 3 year follow-up. Major (temporary) complications for the 59 included symptomatic cerebral edema (7), seizure (2), and hemorrhage (1). Major permanent complications occurred in one patient suffering a cranial nerve V deafferentation, and in two patients suffering a hemorrhage.

Conclusion:

GKS for cerebral AVM's offers an effective and safe method of treatment, with low permanent complication rate.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 6 , November 2011 , pp. 851 - 857
Copyright
Copyright © The Canadian Journal of Neurological 2011

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