Abstract
Objects
The authors report their experience of gamma knife radiosurgery (GKR) in a large series of pediatric cerebral arteriovenous malformations (cAVMs). The advantages, risks and failures of this approach are presented and discussed.
Methods
Gamma knife radiosurgery was performed on 63 children aged ≤16 years. Haemorrhage was the clinical onset in 50 out of 63 cases. The mean pre-GK cAVM volume was 3.8 cm3. Fifty-eight out of 63 cAVMs were Spetzler-Martin grades I–III. Most lesions (47 out of 63) were in eloquent or deep-seated brain regions.
Conclusion
Gamma knife radiosurgery-related complications occurred in 2 out of 47 cases with an available follow-up (1 had transient and 1 permanent morbidity). No bleeding occurred during the latency period. In 39 children with >36-month follow-up, complete cAVM occlusion was angiographically documented in 31, with a 3- and 4-year actuarial obliteration rate of 72 and 77% respectively. High rates of complete obliteration and very low frequency of permanent morbidity with no bleeding during the latency period encourage widespread application of GKR in the treatment of pediatric cAVMs.
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A commentary on this paper is available at http://dx.doi.org/10.1007/s00381-004-1050-z
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Nicolato, A., Foroni, R., Seghedoni, A. et al. Leksell gamma knife radiosurgery for cerebral arteriovenous malformations in pediatric patients. Childs Nerv Syst 21, 301–307 (2005). https://doi.org/10.1007/s00381-004-1049-5
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DOI: https://doi.org/10.1007/s00381-004-1049-5