Gamma Knife radiosurgery for arteriovenous malformations in pediatric patients
The authors present the results of Gamma Knife stereotactic radiosurgery performed in a series of children with arteriovenous malformations (AVMs).
Between June 2005 and January 2014, 75 patients 18 years old or younger received Gamma Knife radiosurgery for AVMs. Of these, 58 patients were eligible for further analysis. The median age of the population was 12 years; 41 % presented with hemorrhage, 34 % with neurological insult, and 24 % patients were diagnosed incidentally. The median AVM volume was 3.5 cm3. The median radiosurgery-based AVM score (RSBAVMS) was 0.86. The median follow-up period was 32 months.
Single session Gamma Knife radiosurgery resulted in complete AVM obliteration in 40 (68.9 %) patients. There were 35 (60.3 %) excellent outcome (complete obliteration with no new deficits) in this series. During the follow-up period, nine (15.51 %) patients experienced new deficits and three (5.1 %) patients experienced intracranial hemorrhage. The annual rate of developing new deficits and hemorrhage was calculated as 5.45 and 1.8 %, respectively. Volume, gender, RSBAVMS, and nidus type factor were factors associated with excellent outcome.
Radiosurgery was successful in majority of patients with minimal morbidity. Gamma Knife radiosurgery for AVMs can be a safe and successful method in pediatric patients.
KeywordsAVM Gamma knife Pediatric neurosurgery Stereotactic radiosurgery
- 8.Nataraj A, Mohamed MB, Gholkar A, Vivar R, Watkins L, Aspoas R, Gregson B, Mitchell P, Mendelow AD (2013) Multimodality treatment of cerebral arteriovenous malformations. World neurosurgeryGoogle Scholar
- 9.Nicolato A, Foroni R, Seghedoni A, Martines V, Lupidi F, Zampieri P, Sandri MF, Ricci U, Mazza C, Beltramello A, Gerosa M, Bricolo A (2005) Leksell gamma knife radiosurgery for cerebral arteriovenous malformations in pediatric patients. Child’s Nerv Syst : ChNS : Off J Int Soc Pediatr Neurosurg 21:301–307, discussion 308CrossRefGoogle Scholar
- 10.Nicolato A, Lupidi F, Sandri MF, Foroni R, Zampieri P, Mazza C, Maluta S, Beltramello A, Gerosa M (2006) Gamma knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period. Int J Radiat Oncol Biol Phys 64:904–913PubMedCrossRefGoogle Scholar
- 11.Nicolato A, Lupidi F, Sandri MF, Foroni R, Zampieri P, Mazza C, Pasqualin A, Beltramello A, Gerosa M (2006) Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part II: differences in obliteration rates, treatment-obliteration intervals, and prognostic factors. Int J Radiat Oncol Biol Phys 64:914–921PubMedCrossRefGoogle Scholar