Long-term outcomes of stereotactic radiosurgery for arteriovenous malformations in the thalamus

Neurosurgery
Tomoyuki KogaNobuhito Saito

Abstract

Arteriovenous malformations (AVMs) in the thalamus carry a high risk of hemorrhage. Although stereotactic radiosurgery (SRS) is widely accepted because of the high surgical morbidity and mortality of these lesions, precise long-term outcomes are largely unknown. To review our experience with SRS for thalamic AVMs based on the latest follow-up data. Forty-eight patients with thalamic AVMs were treated by SRS using the Leksell Gamma Knife and were followed. Long-term outcomes including the obliteration rate, hemorrhage after treatment, and adverse effects were retrospectively analyzed. The annual hemorrhage rate before SRS was 14%. The mean follow-up period after SRS was 66 months (range 6-198 months). The actuarial obliteration rate confirmed by angiography was 82% at 5 years after treatment, and the annual hemorrhage rate after SRS was 0.36%. Factors associated with higher obliteration rates were previous hemorrhage (P = .004) and treatment using new planning software (P = .001). Persistent worsening of neurological symptoms was observed in 17% and more frequently seen in patients who were treated using older planning software (P = .04) and a higher margin dose (P = .02). The morbidity rate for patients who received treatment p...Continue Reading

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Citations

Mar 4, 2011·Neurosurgery·Tomoyuki KogaNobuhito Saito
Jan 24, 2012·Journal of Neurosurgery·Ching-Hsiao ChengJason P Sheehan
May 18, 2013·Surgical Neurology International·Benjamin P Jonker
Jan 7, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Or Cohen-InbarJason P Sheehan
Oct 22, 2011·International Journal of Radiation Oncology, Biology, Physics·Tomoyuki KogaNobuhito Saito
May 9, 2015·Journal of Neurosurgery. Pediatrics·Shunya HanakitaNobuhito Saito
Apr 15, 2014·International Journal of Radiation Oncology, Biology, Physics·Jona A Hattangadi-GluthHelen A Shih
Nov 22, 2011·International Journal of Radiation Oncology, Biology, Physics·Jona A HattangadiHelen A Shih

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