Abstract
Stereotactic radiosurgery (SRS) is an accepted management strategy for many patients with intracranial arteriovenous malformations (AVM). The goal of AVM SRS is nidus obliteration without new neurologic deficits from either radiation-related complications or post-SRS hemorrhage. Over the past 30 years, advances in neuroimaging, dose-planning software, and radiation delivery devices have improved patient outcomes after AVM SRS. The most important factor associated with nidus obliteration is the radiation dose delivered to the margin of the AVM. Patients receiving an AVM margin dose of 15 Gy have a 60–70 % chance of obliteration whereas patients receiving ≥20 Gy have an approximately 90 % chance of cure. Radiation-related complications relate to the overall brain radiation exposure, which is a function of treatment volume and prescribed radiation dose. Patients with AVMs in deep locations such as the basal ganglia, thalamus, and brainstem are at greatest risk for radiation-related complications. The primary drawback of AVM SRS when compared to surgical resection is that the patient remains at risk for hemorrhage until the AVM has gone onto complete obliteration. Recent studies have shown that the risk of bleeding is either unchanged or decreased following AVM SRS. The radiosurgery-based AVM score (RBAS) was developed to predict outcomes after AVM SRS. Based on three factors (AVM volume, patient age, AVM location), the RBAS has been validated by numerous centers using the Gamma Knife®, modified LINAC, and the CyberKnife®. The RBAS allows an accurate prediction of outcomes from SRS to assist in the management for individual AVM patients.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
McCormick WE. Pathology of vascular malformations of the brain. In: Wilson CB, Stein B, editors. Intracranial arteriovenous malformations. Baltimore: Williams and Wilkins; 1984. p. 44–63.
Padget DH. The cranial venous system in man in reference to development, adult configuration, and relation to arteries. Am J Anat. 1956;98:307–55.
Takashima S, Becker LE. Neuropathology of cerebral arteriovenous malformations in children. J Neurol Neurosurg Psychiatry. 1980;43:380–5.
Al-Shahi R, Bhattacharya JJ, Currie DG, Papanastassiou V, Ritchie V, Roberts RC, Sellar RJ, Warlow CP, SIVMS Collaborators. Prospective, population-based detection of intracranial vascular malformations in adults: the Scottish Intracranial Vascular Malformation Study (SIVMS). Stroke. 2003;34:1163–9.
Stapf C, Mast H, Sciacca RR, Berenstein A, Nelson PK, Gobin YP, Pile-Spellman J, Mohr JP. The New York Islands AVM Study: design, study progress, and initial results. Stroke. 2003;34:29–33.
Brown Jr RD, Wiebers DO, Forbes G, O’Fallon WM, Piepgras DG, Marsh WR, Maciunas RJ. The natural history of unruptured intracranial arteriovenous malformations. J Neurosurg. 1988;68:352–7.
Crawford PM, West CR, Chadwick DW, Shaw MDM. Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg Psychiatry. 1986;49:1–10.
Fults D, Kelly Jr DL. Natural history of arteriovenous of the brain: a clinical study. Neurosurgery. 1984;15:658–62.
Graf CJ, Perret GB, Torner JC. Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg. 1983;58:331–7.
Itoyama Y, Uemura S, Ushio Y, Kuratsu J, Nonaka N, Wada H, Sano Y, Fukumura A, Yoshida K, Yano T. Natural course of unoperated intracranial arteriovenous malformations: study of 50 cases. J Neurosurg. 1989;71:805–9.
Ondra SK, Troupp H, George ED, Schwab K. The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment. J Neurosurg. 1990;73:387–91.
Pollock BE, Flickinger JC, Lunsford LD, Bissonette DJ, Kondziolka D. Factors that predict the bleeding risk of cerebral arteriovenous malformations. Stroke. 1996;27:1–6.
Mast H, Young WL, Koennecke HC, Sciacca RR, Osipov A, Pile-Spellman J, Hacein-Bey L, Duong H, Stein BM, Mohr JP. Risk of spontaneous hemorrhage after diagnosis of cerebral arteriovenous malformation. Lancet. 1997;350:1065–8.
Karlsson B, Lindquist C, Steiner L. The effect of gamma knife surgery on the risk of rupture prior to AVM obliteration. Minim Invasive Neurosurg. 1996;39:21–7.
Stapf C, Khaw AV, Sciacca RR, Hofmeister C, Schumacher HC, Pile-Spellman J, Mast H, Mohr JP, Hartmann A. Effect of age on clinical and morphological characteristics in patients with brain arteriovenous malformations. Stroke. 2003;34:2664–9.
Stapf C, Mohr JP, Pile-Spellman J, Sciacca RR, Hartmann A, Schumacher HC, Mast H. Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation. J Neurol Neurosurg Psychiatry. 2002;73:294–8.
Kondziolka D, Humphreys RP, Hoffman HJ, Hendrick EB, Drake JM. Arteriovenous malformations of the brain in children: a forty year experience. Can J Neurol Sci. 1992;19:40–5.
Khaw AV, Mohr JP, Sciacca RR, Schumacher HC, Hartmann A, Pile-Spellman J, Mast H, Stapf C. Association of infratentorial brain arteriovenous malformations with hemorrhage at initial presentation. Stroke. 2004;35:660–3.
Spetzler RF, Hargraves RW, McCormick PW, Zabramski JM, Flom RA, Zimmerman RS. Relationship of perfusion pressure and size to risk of hemorrhage from arteriovenous malformations. J Neurosurg. 1992;76:918–23.
Kessler I, Riva R, Ruggiero M, Manisour M, Al-Khawaldeh M, Mounayer C. Successful transvenous embolization of brain arteriovenous malformations using onyx in five consecutive patients. Neurosurgery. 2011;69:184–93.
van Rooij WJ, Jacobs S, Sluzewski M, van der Pol B, Beute GN, Sprengers ME. Curative embolization of brain arteriovenous malformations with onyx: patient selection, embolization technique, and results. AJNR Am J Neuroradiol. 2012;33(7):1299–304. doi:10.3174/ajnr.A2947.
Karlsson B, Lindqvist M, Blomgren H, Wan-Yeo G, Soderman M, Lax I, Yamamoto M, Bailes J. Long-term results after fractionated radiation therapy for large brain arteriovenous malformations. Neurosurgery. 2005;57:42–9.
Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986;65:476–83.
de Oliveria E, Tedeschi H, Raso J. Comprehensive management of arteriovenous malformations. Neurol Res. 1998;20:673–83.
Hamilton MG, Spetzler RF. The prospective application of a grading system for arteriovenous malformations. Neurosurgery. 1994;34:2–7.
Heros RC, Korosue K, Diebold PM. Surgical excision of cerebral arteriovenous malformations. Neurosurgery. 1990;26:570–8.
Pik JHT, Morgan MK. Microsurgery for small arteriovenous malformations of the brain: results in 110 consecutive patients. Neurosurgery. 2000;47:571–7.
Pikus HJ, Beach ML, Harbaugh RE. Microsurgical treatment of arteriovenous malformations: analysis and comparison with stereotactic radiosurgery. J Neurosurg. 1998;88:641–6.
Schaller C, Schramm J. Microsurgical results for small arteriovenous malformations accessible for radiosurgical or embolization treatment. Neurosurgery. 1997;40:664–74.
Steiner L, Leksell L, Grietz T, Forster DMC. Stereotaxic radiosurgery for cerebral arteriovenous malformations: report of a case. Acta Chir Scand. 1972;138:459–64.
Leksell L. Stereotactic radiosurgery. J Neurol Neurosurg Psychiatry. 1983;46:797–803.
Kjellberg RN, Hanamura T, Davis KR, Lyons SL, Adams RD. Bragg-peak proton-beam therapy for arteriovenous malformations. N Engl J Med. 1983;309:269–74.
Steinberg GK, Fabrikant JI, Marks MP, Levy RP, Frankel KA, Phillips MH, Shuer LM, Silverberg GD. Stereotactic heavy-charged-particle Bragg-peak radiation for intracranial arteriovenous malformations. N Engl J Med. 1990;323:96–101.
Betti OO, Munari C, Rosler R. Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations. Neurosurgery. 1989;24:311–21.
Columbo F, Pozza F, Chierego G, Casentini L, De Luca G, Francescon P. Linear accelerator radiosurgery of cerebral arteriovenous malformations: an update. Neurosurgery. 1994;34:14–21.
Friedman WA, Bova FJ, Mendenhall WM. Linear accelerator radiosurgery for arteriovenous malformations: the relationship of size to outcome. J Neurosurg. 1995;82:180–9.
Heros RC, Yu YK. Is surgical therapy needed for unruptured arteriovenous malformations? Neurology. 1987;37:279–86.
Han PP, Ponce FA, Spetzler RF. Intention-to-treat analysis of Spetzler-Martin grades IV and V arteriovenous malformations: natural history and treatment paradigm. J Neurosurg. 2003;98:3–7.
Choi JH, Mohr JP. Brain arteriovenous malformations in adults. Lancet Neurol. 2005;4:299–308.
Halim XA, Johnston SC, Singh V, McCulloch CE, Bennett JP, Achrol AS, Sidney S, Young WL. Longitudinal risk of intracranial hemorrhage in patients with arteriovenous malformations of the brain within a defined population. Stroke. 2004;35:1697–702.
Stapf C, Mast H, Sciacca RR, Choi JH, Khaw AV, Connolly ES, Pile-Spellman J, Mohr JP. Predictors of hemorrhage in patients with untreated brain arteriovenous malformation. Neurology. 2006;66:1350–5.
Hartmann A, Mast H, Mohr JP, Koennecke HC, Osipov A, Pile-Spellman J, Duong DH, Young WL. Morbidity of intracranial hemorrhage in patients with cerebral arteriovenous malformation. Stroke. 1998;29:931–4.
van Beijnum J, Lovelock CE, Cordonnier C, Rothwell PM, Klijn CJM, Salman RA. Outcome after spontaneous and arteriovenous malformation-related intracerebral haemorrhage: population-based studies. Brain. 2009;132:537–43.
Hartmann A, Stapf C, Hofmeister C, Mohr JP, Sciacca RR, Stein BM, Faulstich A, Mast H. Determinants of neurological outcome after surgery for brain arteriovenous malformations. Stroke. 2000;31:2361–4.
Lawton MT, Du R, Tran MN, Nelson M, Achrol A, McCulloch CE, Johnston SC, Quinnine NJ, Young WL. Effect of presenting hemorrhage on outcome after microsurgical resection of brain arteriovenous malformations. Neurosurgery. 2005;56:485–93.
Mohr JP, Moskowitz AJ, Parides M, Stapf C, Young WL. Hull down on the horizon. A randomized trial of unruptured brain arteriovenous malformations (ARUBA) trial. Stroke. 2012;43: 1744–5.
Cockroft KM, Jayaraman MV, Amin-Hanjani S, Derdeyn CP, McDougall CG, Wilson JA. A perfect storm: how a randomized trial of unruptured brain arteriovenous malformations’ (ARUBA’s) trial design challenges notions of external validity. Stroke. 2012;43:1979–81.
Pollock BE, Flickinger JC. A proposed radiosurgery-based grading system for arteriovenous malformations. J Neurosurg. 2002;96:79–85.
Pollock BE, Flickinger JC. Modification of the radiosurgery-based arteriovenous malformation grading system. Neurosurgery. 2008;63:239–43.
Englot DJ, Young WL, Han SJ, McCulloch CE, Chang EF, Lawton MT. Seizure predictors and control after microsurgical resection of supratentorial arteriovenous malformations in 440 patients. Neurosurgery. 2012;71:572–80.
Piepgras DG, Sundt Jr TM, Ragoowansi AT, Stevens L. Seizure outcome in patients with surgically treated cerebral arteriovenous malformations. J Neurosurg. 1993;78:5–11.
Schäuble B, Cascino GD, Pollock BE, Gorman DA, Weigand S, Cohen-Godal A, McClelland RL. Seizure outcomes after stereotactic radiosurgery for cerebral arteriovenous malformations. Neurology. 2004;63:683–7.
Yang S, Kim DG, Chung H, Paek SH. Radiosurgery for unruptured cerebral arteriovenous malformations. Long-term seizure outcome. Neurology. 2012;78:1292–8.
Blatt DR, Friedman WA, Bova FJ. Modifications based on computed tomographic imaging in planning the radiosurgical treatment of arteriovenous malformations. Neurosurgery. 1993;33: 588–95.
Flickinger JC, Pollock BE, Kondziolka D, Lunsford LD. A dose-response analysis of arteriovenous malformation obliteration by radiosurgery. Int J Radiat Oncol Biol Phys. 1996;36:873–9.
Karlsson B, Lindquist C, Steiner L. Prediction of obliteration after gamma knife surgery for cerebral arteriovenous malformations. Neurosurgery. 1997;40:425–31.
Flickinger JC. An integrated logistic formula for prediction of complications from radiosurgery. Int J Radiat Oncol Biol Phys. 1989;17:879–85.
Flickinger JC, Kondziolka D, Lunsford LD, Liscak R, Phuong LK, Pollock BE. Development of a model to predict permanent symptomatic post-radiosurgery injury for arteriovenous malformation patients. Int J Radiat Oncol Biol Phys. 2000;46:1143–8.
Lax I, Karlsson B. Prediction of complications in gamma knife radiosurgery of arteriovenous malformations. Acta Oncol. 1996;35:49–56.
Pollock BE, Kondziolka D, Lunsford LD, Patel A, Bissonette DJ, Flickinger JC. Magnetic resonance imaging: an accurate method to evaluate arteriovenous malformations after stereotactic radiosurgery. J Neurosurg. 1996;85:1044–9.
Buis DR, Bot JCJ, Barkhof F, Knol DL, Lagerwaard FJ, Slotman BJ, Vandertop WP, van den Berg R. The predictive value of 3D time-of-flight angiography in assessment of brain arteriovenous malformation obliteration after radiosurgery. AJNR Am J Neuroradiol. 2012;33:232–8.
Lindquist C, Steiner L. Stereotactic radiosurgical treatment of arteriovenous malformations. In: Lunsford LD, editor. Modern stereotactic neurosurgery. Boston: Martinus Nijhoff Publishing; 1988. p. 491–505.
Schneider BF, Eberhard DA, Steiner LE. Histopathology of arteriovenous malformations after gamma knife radiosurgery. J Neurosurg. 1997;87:352–7.
Major O, Szeifert GT, Fazekas I, Vitanovics D, Csonka E, Kocsis B, Bori Z, Kemeny AA, Nagy Z. Effects of single high-dose gamma irradiation on cultured cells in human cerebral arteriovenous malformation. J Neurosurg. 2002;97(5 Suppl):459–63.
Szeifert GT, Major O, Kemeny AA. Ultrastructural changes in arteriovenous malformations after gamma knife surgery: an electron microscopic study. J Neurosurg. 2005;102(Suppl):289–92.
Kano H, Lunsford LD, Flickinger JC, Yang H, Flannery TJ, Awan NR, Niranjan A, Novotny J, Kondziolka D. Stereotactic radiosurgery for arteriovenous malformations, part 1: management of Spetzler-Martin grade I and II arteriovenous malformations. J Neurosurg. 2012;116:11–20.
Kano H, Kondziolka D, Flickinger JC, Yang H, Flannery TJ, Niranjan A, Novotny J, Lunsford LD. Stereotactic radiosurgery for arteriovenous malformations, part 4: management of basal ganglia and thalamus arteriovenous malformations. J Neurosurg. 2012;116:33–43.
Kano H, Kondziolka D, Flickinger JC, Yang H, Flannery TJ, Ninanjan A, Novotny J, Lunsford LD. Stereotactic radiosurgery for arteriovenous malformations, part 5: management of brainstem arteriovenous malformations. J Neurosurg. 2012;116:44–53.
Shin M, Maruyama K, Kurita H, Kawamoto S, Tago M, Terahara A, Morita A, Ueki K, Takakura K, Kirino T. Analysis of nidus obliteration rates after gamma knife surgery for arteriovenous malformations based on long-term follow-up data: the University of Tokyo experience. J Neurosurg. 2004;101:18–24.
Schwartz M, Sixel K, Young C, Kemeny A, Forster D, Walton L, Franssen E. Prediction of obliteration of arteriovenous malformations: the obliteration prediction index. Can J Neurol Sci. 1997;24: 106–9.
Ellis TL, Friedman WA, Bova FJ, Kubilis PS, Buatti JM. Analysis of treatment failure after radiosurgery for arteriovenous malformations. J Neurosurg. 1998;89:104–10.
Kano H, Kondziolka D, Flickinger JC, Yang H, Flannery TJ, Awan NR, Niranjan A, Novotny J, Lunsford LD. Stereotactic radiosurgery for arteriovenous malformations, part 3: outcome predictors and risks after repeat radiosurgery. J Neurosurg. 2012;116:21–32.
Gallina P, Merienne L, Meder JF, Schlienger M, Lefkopoulos D, Merland J. Failure in radiosurgery treatment of cerebral arteriovenous malformations. Neurosurgery. 1998;42:996–1004.
Buis DR, Lagerwaard FJ, Barkhof F, Dirven CMF, Lycklama GJ, Meijer OWM, van den Berg R, Langendijk HA, Slotman BJ, Vandertopet WP. Stereotactic radiosurgery for brain AVMs: role of interobserver variation in target definition on digital subtraction angiography. Int J Radiat Oncol Biol Phys. 2005;62:246–52.
Yu C, Petrovich Z, Apuzzo ML, Zelman V, Giannotta SL. Study of magnetic resonance imaging-based arteriovenous malformation delineation without conventional angiography. Neurosurgery. 2004;54:1104–7.
Zipfel GJ, Bradshaw P, Bova FJ, Friedman WA. Do the morphological characteristics of arteriovenous malformations affect the results of radiosurgery? J Neurosurg. 2004;101:393.
Taeshineetanakul P, Krings T, Geibprasert S, Menezes R, Agid R, Terbrugge K, Schwartz ML. Angioarchitecture determines obliteration rate after radiosurgery in brain arteriovenous malformations. Neurosurgery. 2012;71(6):1071–8. doi:10.1227/NEU.ob013e31826f79ec.
Pollock BE, Lunsford LD, Kondziolka D, Maitz A, Flickinger JC. Patient outcomes after stereotactic radiosurgery for “operable” arteriovenous malformations. Neurosurgery. 1994;35:1–8.
Friedman WA, Blatt DL, Bova FJ, Buatti JM, Mendenhall WM, Kubilis PS. The risk of hemorrhage after radiosurgery for arteriovenous malformations. J Neurosurg. 1996;84:912–9.
Nataf F, Ghossoub M, Schlienger M, Moussa R, Meder J, Roux F. Bleeding after radiosurgery for cerebral arteriovenous malformations. Neurosurgery. 2004;55:298–305.
Pollock BE, Flickinger JC, Lunsford LD, Bissonette DJ, Kondziolka D. Hemorrhage risk after stereotactic radiosurgery of cerebral arteriovenous malformations. Neurosurgery. 1996;38: 652–61.
Karlsson B, Lax I, Söderman M. Risk of hemorrhage during the 2-year latency period following gamma knife radiosurgery for arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2001;49:1045–51.
Maruyama K, Kawahara N, Shin M, Tago M, Kishimoto J, Kurita H, Kawamoto S, Morita A, Kirino T. The risk of hemorrhage after radiosurgery for cerebral arteriovenous malformations. N Engl J Med. 2005;352:146–53.
Lindqvist M, Karlsson B, Guo W, Kihlstrom L, Lippitz B, Yamamoto M. Angiographic long-term follow-up data for arteriovenous malformations previously proven to be obliterated after gamma knife radiosurgery. Neurosurgery. 2000;46:803–10.
Shin M, Kawahara N, Maruyama K, Tago M, Ueki K, Kirino T. Risk of hemorrhage from an arteriovenous malformation confirmed to have been obliterated on angiography after stereotactic radiosurgery. J Neurosurg. 2005;102:842–6.
Levegrun S, Hof H, Essig M, Schlegel W, Debus J. Radiation-induced changes of brain tissue after radiosurgery in patients with arteriovenous malformations: correlation with dose distribution parameters. Int J Radiat Oncol Biol Phys. 2004;59:796–808.
Pollock BE. Occlusive hyperemia. A radiosurgical phenomenon? Neurosurgery. 2000;47:1178–84.
Chapman PH, Ogilvy CS, Loeffler JS. The relationship between occlusive hyperemia and complications associated with the radiosurgical treatment of arteriovenous malformations: report of two cases. Neurosurgery. 2004;55:228–34.
Pollock BE, Gorman DA, Brown PD. Radiosurgery for arteriovenous malformations of the basal ganglia, thalamus, and brainstem. J Neurosurg. 2004;100:210–4.
Yamamoto M, Ban S, Ide M, Jimbo M. A diffuse white matter ischemic lesion appearing 7 years after stereotactic radiosurgery for cerebral arteriovenous malformations: case report. Neurosurgery. 1997;41:1405–9.
Kihlström L, Guo W, Karlsson B, Lindquist C, Lindqvist M. Magnetic resonance imaging of obliterated arteriovenous malformations up to 23 years after radiosurgery. J Neurosurg. 1997;86:589–93.
Pollock BE, Brown Jr RD. Management of cysts arising after radiosurgery of intracranial arteriovenous malformations. Neurosurgery. 2001;49:259–65.
Yamamoto M, Jimbo M, Hara M, Saito I, Mori K. Gamma knife radiosurgery for arteriovenous malformations: long-term follow-up results focusing on complications occurring more than 5 years after irradiation. Neurosurgery. 1996;38:906–14.
Yamamoto M, Ide M, Jimbo M, Ono Y. Middle cerebral artery stenosis caused by relatively low-dose irradiation with stereotactic radiosurgery for cerebral arteriovenous malformations: case report. Neurosurgery. 1997;41:474–7.
Kaido T, Hoshida T, Uranishi R, Akita N, Kotani A, Nishi N, Sakaki T. Radiosurgery-induced brain tumor: case report. J Neurosurg. 2001;95:710–3.
Loeffler JS, Niemierko A, Chapman PH. Second tumors after radiosurgery: tip of the iceberg or a bump in the road? Neurosurgery. 2003;52:1436–42.
Karlsson B, Kihlstrom L, Lindquist C, Steiner L. Gamma knife surgery for previously irradiated arteriovenous malformations. Neurosurgery. 1998;42:1–5.
Schlienger M, Nataf F, Lefkopoulos D, Mammar H, Missir O, Meder J, Huart J, Platoni P, Deniaud-Alexandre E, Merienne L. Repeat linear accelerator radiosurgery for cerebral arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2003;56:529–36.
Stahl JM, Chi Y, Friedman WA. Repeat radiosurgery for intracranial arteriovenous malformations. Neurosurgery. 2012;70:150–4.
Miyawaki L, Dowd C, Wara W, Goldsmith B, Albright N, Gutin P, Halbach V, Hieshima G, Higashida R, Lulu B, Pitts L, Schell M, Smith V, Weaver K, Wilson C, Larson D. Five year results of LINAC radiosurgery for arteriovenous malformations: outcome for large AVMs. Int J Radiat Oncol Biol Phys. 1999;44:1089–96.
Blackburn SL, Ashley Jr WM, Rich KM, Simpson JR, Drzymala RE, Ray WZ, Moran CJ, Cross III DT, Chicoine MR, Dacey Jr RG, Derdeyn CP, Zipfel GJ. Combined endovascular embolization and stereotactic radiosurgery in the treatment of large arteriovenous malformations. J Neurosurg. 2011;114:1758–67.
Gobin YP, Laurent A, Merienne L, Schlienger M, Aymard A, Houdart E, Casasco A, Lefkopoulos D, George B, Merland JJ. Treatment of brain arteriovenous malformations by embolization and radiosurgery. J Neurosurg. 1996;85:19–28.
Lawton MT, Hamilton MG, Spetzler RF. Multimodality treatment of deep arteriovenous malformations: thalamus, basal ganglia, and brain stem. Neurosurgery. 1995;37:29–36.
Pandey P, Marks MP, Harraher CD, Westbroek EM, Chang SD, Levy RP, Dodd RL, Steinberg GK. Multimodality management of Spetzler-Martin Grade III arteriovenous malformations. J Neurosurg. 2012;116:1279–88.
Redekop GJ, Elisevich KV, Gaspar LE, Wiese KP, Drake CG. Conventional radiation therapy of intracranial arteriovenous malformations: long-term results. J Neurosurg. 1993;78:413–22.
Chang T, Shirato H, Aoyama H, Ushikoshi S, Kato N, Kuroda S, Ishikawa T, Houkin K, Iwasaki Y, Miyasaka K. Stereotactic irradiation for intracranial arteriovenous malformations using stereotactic radiosurgery or hypofractionated stereotactic radiotherapy. Int J Radiat Oncol Biol Phys. 2004;60:861–70.
Hattangadi JA, Chapman PH, Bussiere MR, Niemierko A, Ogilvy CS, Rowell A, Daartz J, Loeffler JS, Shih HA. Planned two-fraction proton beam stereotactic radiosurgery for high-risk inoperable cerebral arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2012;83:533–41.
Lindvall P, Bergström P, Löfroth P, Hariz M, Henriksson R, Jonasson P, Bergenheim AT. Hypofractionated conformal stereotactic radiotherapy for arteriovenous malformations. Neurosurgery. 2003;53:1036–42.
Veznedaroglu E, Andrews D, Benitez R, Downes MB, Werner-Wasik M, Rosenstock J, Curran WJ, Rosenwasser RH. Fractionated stereotactic radiotherapy for the treatment of large arteriovenous malformations with or without previous partial embolization. Neurosurgery. 2004;55:519–30.
Huang PP, Rush SC, Donahue B, Narayana A, Becske T, Nelson PK, Han K, Jafar JJ. Long-term outcomes after staged-volume radiosurgery for large arteriovenous malformations. Neurosurgery. 2012;71:632–44.
Kano H, Kondziolka D, Flickinger JC, Park K, Parry PV, Yang H, Sirin S, Niranjan A, Novotny J, Lunsford LD. Stereotactic radiosurgery for arteriovenous malformations, part 6: multistaged volumetric management of large arteriovenous malformations. J Neurosurg. 2012;116:54–65.
Pollock BE, Kline RW, Stafford SL, Foote RL, Schomberg PJ. The rationale and technique of staged-volume arteriovenous malformation radiosurgery. Int J Radiat Oncol Biol Phys. 2000;48: 817–24.
Lawton MT. Spetzler-Martin grade III arteriovenous malformations: surgical results and modification of the grading scale. Neurosurgery. 2003;52:740–8.
Morgan MK, Drummond KJ, Grinnell V, Sorby W. Surgery for cerebral arteriovenous malformations: risks related to lenticulostriate arterial supply. J Neurosurg. 1997;86:801–5.
Andrade-Souza YM, Zadeh G, Ramani M, Scora D, Tsao MN, Schwartz ML. Testing the radiosurgery-based arteriovenous malformation score and the modified Spetzler-Martin grading system to predict radiosurgical outcome. J Neurosurg. 2005;103:642–8.
Andrade-Souza Y, Zadeh G, Scora D, Tsao MN, Schwartz ML. Radiosurgery for basal ganglia, internal capsule, and thalamus arteriovenous malformations: clinical outcomes. Neurosurgery. 2005;56:56–64.
Cohen-Gadol AA, Pollock BE. Radiosurgery for pediatric arteriovenous malformations. J Neurosurg. 2006;104(6 Suppl):388–91.
Colombo F, Cavedon C, Casentini L, Francescon P, Causin F, Pinna V. Early results of CyberKnife radiosurgery for arteriovenous malformations. J Neurosurg. 2009;111:807–19.
Lee JS, Girvigian MR, Miller MJ, Rahimian J, Chen JCT, Greathouse HE, Tome M. Validation of a radiosurgery-based grading system for arteriovenous malformations. Radiosurgery. 2006; 6:221–8.
Maruyama K, Kondziolka D, Niranjan A, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for brainstem arteriovenous malformations: factors affecting outcome. J Neurosurg. 2004;100: 407–13.
Maruyama K, Shin M, Tago M, Kurita H, Kawamoto S, Morita A, Kirino T. Gamma knife surgery for arteriovenous malformations involving the corpus callosum. J Neurosurg. 2005;102(Suppl): 49–52.
Pollock BE, Brown Jr RD. Use of the modified rankin scale to assess outcome after arteriovenous malformation radiosurgery. Neurology. 2006;67:1630–4.
Raffa SJ, Chi YY, Bova FJ, Friedman WA. Validation of the radiosurgery-based arteriovenous malformation score in a large linear accelerator radiosurgery experience. J Neurosurg. 2009; 111:832–9.
Wegner RE, Oysul K, Pollock BE, Sirin S, Kondziolka D, Niranjan A, Lunsford LD, Flickinger JC. A modified radiosurgery-based arteriovenous malformation grading scale and correlation with outcomes. Int J Radiat Oncol Biol Phys. 2011;79:1147–50.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Pollock, B.E. (2015). Arteriovenous Malformation Radiosurgery. In: Chin, L., Regine, W. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8363-2_47
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8363-2_47
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8362-5
Online ISBN: 978-1-4614-8363-2
eBook Packages: MedicineMedicine (R0)