Gamma Knife Radiosurgery for Incidental, Symptomatic Unruptured, and Ruptured Brain Arteriovenous Malformations
| Autor: | Seung-Chyul Hong, Jung-Il Lee, Jong-Soo Kim, Byung Sup Kim, Yong Soon Hwang, Je Young Yeon, Hyung Shik Shin, Hyung Jin Shin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Intracranial Arteriovenous Malformations Male medicine.medical_specialty Time Factors Adolescent Age at diagnosis Gamma knife radiosurgery Postoperative Hemorrhage Radiosurgery Risk Assessment Young Adult Risk Factors medicine Humans In patient Child Aged Retrospective Studies Incidental Findings Natural course Rupture Spontaneous business.industry Significant difference Age Factors Infant Arteriovenous malformation Mean age Middle Aged medicine.disease Treatment Outcome Neurology Child Preschool Female Neurology (clinical) Radiology Cardiology and Cardiovascular Medicine business Intracranial Hemorrhages RUPTURED AVM |
| Zdroj: | Cerebrovascular Diseases. 50:222-230 |
| ISSN: | 1421-9786 1015-9770 |
| DOI: | 10.1159/000513280 |
| Popis: | Background: This study was performed to investigate clinical characteristics and outcome after gamma knife radiosurgery (GKS) in patients with incidental, symptomatic unruptured, or ruptured arteriovenous malformations (AVMs). Methods: A total of 491 patients with brain AVMs treated with GKS from June 2002 to September 2017 were retrospectively reviewed. All patients were classified into the incidental (n = 105), symptomatic unruptured (n = 216), or ruptured AVM (n = 170) groups. Results: The mean age at diagnosis of incidental, symptomatic unruptured, and ruptured AVMs was 40.3, 36.7, and 27.6 years, respectively. The mean nidus volume was 3.9, 5.7, and 2.4 cm3, respectively. Deep venous drainage was identified in 34, 54, and 76% patients, respectively. There were no significant differences in obliteration rates after GKS between the 3 groups (64.8, 61.1, and 65.9%, respectively) after a mean follow-up period of 60.5 months; however, patients with incidental AVM had a significantly lower post-GKS hemorrhage rate than patients with symptomatic unruptured or ruptured AVMs (annual hemorrhage rate of 1.07, 2.87, and 2.69%; p = 0.028 and p = 0.049, respectively). Conclusions: There is a significant difference in clinical and anatomical characteristics between incidental, symptomatic unruptured, and ruptured AVMs. The obliteration rate after GKS is not significantly different between the 3 groups. Meanwhile, an older age at diagnosis and lower hemorrhage rate after GKS in incidental AVMs suggest that they have a more indolent natural course with a lower life-long risk of hemorrhage. |
| Databáze: | OpenAIRE |
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