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Angiographic Follow-up of One-Stage Radiosurgery for Multiple Cerebral Arteriovenous Malformations

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Journal of Radiosurgery

Abstract

Because multiple cerebral arteriovenous malformations (AVMs) are extremely rare, little information is available as to stereotactic radiosurgery for multiple AVMs. We present a patient with three cerebral AVMs who underwent one stage gamma knife radiosurgery for all three nidi. Each nidus was covered with a 90% isodose volume and a central dose of 27.8 Gy was used to obtain a marginal dose of 25 Gy. Angiography that was performed 10 months after irradiation demonstrated complete obliteration in one nidus, remarkable shrinkage in another and no significant changes in the other. The patient has experienced neither bleeding nor complications related to irradiation, to date. We consider one of the major benefits of stereotactic radiosurgery to be that multiple intracranial AVMs, if all nidi are sufficiently small (<3 cm), can be treated with a single procedure.

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REFERENCES

  1. Drake CG, Friedman AH, Peerless SJ: Posterior fossa arteriovenous malformations. J Neurosurg 64:1–10, 1986

    Google Scholar 

  2. Fong D, Chan ST: Arteriovenous malformation in children. Childs Nervous System 4:199–203, 1988

    Google Scholar 

  3. Paterson JH, McKissock W: A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 79:233–66, 1956

    Google Scholar 

  4. Rigamonti D, Spetzler RF, Johnson PC, Drayer BP, Carter LP, Ueda T: Cerebral vascular malformations. Barrow Neurol Inst Q 3:18–27, 1987

    Google Scholar 

  5. Salcman M, Scholtz H, Numaguchi Y: Multiple intracerebral arteriovenous malformations: report of three cases and review of the literature. Surg Neurol 38:121–128, 1992

    Google Scholar 

  6. Schlachter LB, Fleischer AS, Faria MA, Tindal GT: Multifocal intracranial arteriovenous malformations. Neurosurgery 7:440–444, 1980

    Google Scholar 

  7. Tamaki N, Fujita K, Yamashita H: Multiple arteriovenous malformations involving the scalp, dura, retina, cerebrum, and posterior fossa: case report. J Neurosurg 34:95–98, 1971

    Google Scholar 

  8. Yasargil MG: Microneurosurgery, III A, AVM of the Brain, History, Embryology, Pathological Considerations, Hemodynamics, Diagnostic Studies, Microsurgical Anatomy. Stuttgart, Thiem Medical, 1988, pp 165–182

    Google Scholar 

  9. Betti OO, Munari C, Rosler R: Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations. Neurosurgery 24:311–321, 1989

    Google Scholar 

  10. Colombo F, Benedetti A, Pozza F, Marchetti C, Chierego G: Linear accelerator radiosurgery of cerebral arteriovenous malformations. Neurosurgery 24:833–840, 1989

    Google Scholar 

  11. Colombo F, Pozza F, Chierego G, Casentini L, De Luca G, Francescon P: Linear accelerator radiosurgery of cerebral arteriovenous malformations: an update. Neurosurgery 34:14–21, 1994

    Google Scholar 

  12. Fabrikant JI, Frankel KA, Phillips MH, Levy RP: Stereotactic heavy charged-particle Bragg peak radiosurgery for intracranial arteriovenous malformations. In Cerebral Vascular Diseases in Children and Adolescents. MSB Edwards, HJ Hoffman (eds). Baltimore, Williams & Wilkins, 1989, pp 389–409

    Google Scholar 

  13. Fabrikant JI, Lyman JT, Hosobuchi Y: Stereotactic heavy-ion Bragg peak radiosurgery for intracranial vascular disorders: Method for treatment of deep arteriovenous malformations. Br J Radiol 57:479–490, 1984

    Google Scholar 

  14. Friedman WA, Bova FJ: Linear accelerator radiosurgery for arteriovenous malformations. J Neurosurg 77:832–841, 1992

    Google Scholar 

  15. Friedman WA, Bova FJ, Mendenhall WM: Linear accelerator radiosurgery for arteriovenous malformations: the relationship of size to outcome. J Neurosurg 82:180–189, 1995

    Google Scholar 

  16. Jimbo M, Kitamura K, Steiner L: Radiotherapy to cerebral arteriovenous malformation. In Neurosurgeons, vol. 6 (Proceedings of the 7th Annual Meeting of the Japanese Congress of Neurological Surgeons). K Hirakawa (ed). Tokyo, Scimed Publications, 1987, pp 254–257 (in Japanese, English abstract)

    Google Scholar 

  17. Kawamoto S: Radiosurgery of arteriovenous malformations. No-Shinkei-Geka (Neurol Surg, Tokyo) 22:403–420, 1994 (in Japanese)

    Google Scholar 

  18. Kjellberg RN, Hanamura T, Davis KR, Lyons SL, Adams RD: Bragg-peak proton-beam therapy for arteriovenous malformations of the brain. N Engl J Med 309:269–274, 1983

    Google Scholar 

  19. Levy RP, Fabrikant JI, Frankel KA, Phillips MH, Lyman JT: Stereotactic heavy-charged-particle Bragg peak radiosurgery for the treatment of intracranial arteriovenous malformations in childhood and adolescence. Neurosurgery 24:841–852, 1989

    Google Scholar 

  20. Lindquist C, Steiner L: Stereotactic radiosurgical treatment of arteriovenous malformations. In Modern Stereotactic Neurosurgery. LD Lunsford (ed). Boston, Nijhoff, 1988, pp 491–505

    Google Scholar 

  21. Loeffler JS, Rossitch E Jr, Siddon R, Moore MR, Rockoff MA, Alexander E III: Role of stereotactic radiosurgery with a linear accelerator in treatment of intracranial arteriovenous malformations and tumors in children. Pediatrics 85:774–784, 1990

    Google Scholar 

  22. Lunsford LD, Kondziolka D, Flickinger JC, Bissonette DJ, Jungreis CA, Maitz AH: Stereotactic radiosurgery for arteriovenous malformations of the brain. J Neurosurg 75:512–524, 1991

    Google Scholar 

  23. Pollock BE, Lunsford LD, Kondziolka D, Maitz A, Flickinger JC: Patient outcomes after stereotactic radiosurgery for “operable” arteriovenous malformations. Neurosurgery 35:1–8, 1994

    Google Scholar 

  24. Souhami L, Olivier A, Podgorsak EB, Pla M, Pike GB: Radiosurgery of cerebral arteriovenous malformations with the dynamic stereotactic irradiation. Int J Radiatl Oncol Biol Phys 19:775–782, 1990

    Google Scholar 

  25. Steinberg GK, Fabrikant JI, Marks MP, Levy RP, Frankel KA, Phillips MH, et al: Stereotactic heavy-charged particle Bragg peak radiation for intracranial arteriovenous malformations. N Engl J Med 323:96–101, 1990

    Google Scholar 

  26. Steiner L: Treatment of arteriovenous malformation by radiosurgery. In Intracranial Arteriovenous Malformations. CB Wilson, BM Stein (eds.). Baltimore, Williams & Wilkins, 1984, pp 295–313

    Google Scholar 

  27. Steiner L, Lindquist C, Adler JR, Torner JC, Alves W, Steiner M: Clinical outcome of radiosurgery for cerebral arteriovenous malformations. J Neurosurg 77:1–8, 1992

    Google Scholar 

  28. Steiner L, Lindquist C, Steiner M: Radiosurgery. In Advances and Technical Standards in Neurosurgery. L Symon (ed.). Wien, Springer-Verlag, 1992, pp 19–102

    Google Scholar 

  29. Yamamoto Y, Coffey RJ, Nichols DA, Shaw EG: Interim report on the radiosurgical treatment of cerebral arteriovenous malformations: the influence of size, dose, time and technical factors on obliteration rate. J Neurosurg 83:832–837, 1995

    Google Scholar 

  30. Yamamoto M, Ide M, Jimbo M, Aiba M, Ito M, Hirai H, et al: Gamma knife radiosurgery with numerous target points for intracranially disseminated metastases: early experience in three patients and experimental analysis of whole brain irradiation doses. In Radiosurgery 1997. D Kondziolka (ed.). Basel, Karger, 1998

    Google Scholar 

  31. Ericson K, Söderman M, Karlsson B, Lindquist C: Multiple intracranial arteriovenous malformations: a case report. Neuroradiology 36:157–159, 1994

    Google Scholar 

  32. Kikuchi K, Kowada M, Tomura N, Johkura H: Hereditary hemorrhagic teleangiectasia associated with cerebral arteriovenous fistula and multiple cerebral arteriovenous malformations: case report. No-Shinkei-Geka (Neurosurgery, Tokyo) 22:85–91, 1994 (in Japanese, English abstract)

    Google Scholar 

  33. 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 five years after irradiation. Neurosurgery 38:906–914, 1996

    Google Scholar 

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Yamamoto, M., Ide, M., Jimbo, M. et al. Angiographic Follow-up of One-Stage Radiosurgery for Multiple Cerebral Arteriovenous Malformations. Journal of Radiosurgery 1, 213–221 (1998). https://doi.org/10.1023/B:JORA.0000015196.57676.6e

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  • DOI: https://doi.org/10.1023/B:JORA.0000015196.57676.6e

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