BACKGROUND: To our knowledge, there are no reported arteriovenous malformation (AVM) series in which detailed long-term follow-up results after radiosurgery were described based on the whole patient group. METHOD: We performed a detailed long-term follow-up study of 53 patients with cerebral AVMs treated with gamma knife (GK) radiosurgery, with emphasis on radiation-related adverse effects detected on neuro-imaging after a long post-irradiation latency period (3-10 years). The post-GK follow-up period was 40-232 months excluding two mortalities, the mean being 112 and the median being 111 months. RESULTS: Three patients (5.6%) have, as yet, refused all neuro-imaging follow-up studies. Complete nidus obliteration was confirmed angiographically in 32 patients (60.4%) between 1 and 5 post-GK years. In the other 18 patients (34%), despite significant nidus shrinkage being angiographically demonstrated, complete obliteration was not achieved during a 2-7 year follow-up period. There were two mortalities, one AVM-related (massive re-bleeding during the latency period) and the other angiography-related. There were five radiation-related morbidities (9.4%), three of which-hemi-Parkinson syndrome, hemiparesis, and visual field disturbances attributable to delayed cyst formation-manifested at 5.5, 7 and 7 post-GK years, respectively. We also experienced five patients (9.4%) in whom, despite remaining asymptomatic to date, radiation-related adverse effects were seen on neuro-imaging: middle cerebral artery stenosis at 3 post-GK years in one patient; dural arteriovenous fistula at 7 post GK-years in one; delayed cyst formation in two, at 5 and 10 post-GK years; and a small cavitation at 9 post-GK years. CONCLUSION: Long-term follow-up, particularly with neuro-imaging modalities, is essential even after the "treatment goal" has been attained.
BACKGROUND: To our knowledge, there are no reported arteriovenous malformation (AVM) series in which detailed long-term follow-up results after radiosurgery were described based on the whole patient group. METHOD: We performed a detailed long-term follow-up study of 53 patients with cerebral AVMs treated with gamma knife (GK) radiosurgery, with emphasis on radiation-related adverse effects detected on neuro-imaging after a long post-irradiation latency period (3-10 years). The post-GK follow-up period was 40-232 months excluding two mortalities, the mean being 112 and the median being 111 months. RESULTS: Three patients (5.6%) have, as yet, refused all neuro-imaging follow-up studies. Complete nidus obliteration was confirmed angiographically in 32 patients (60.4%) between 1 and 5 post-GK years. In the other 18 patients (34%), despite significant nidus shrinkage being angiographically demonstrated, complete obliteration was not achieved during a 2-7 year follow-up period. There were two mortalities, one AVM-related (massive re-bleeding during the latency period) and the other angiography-related. There were five radiation-related morbidities (9.4%), three of which-hemi-Parkinson syndrome, hemiparesis, and visual field disturbances attributable to delayed cyst formation-manifested at 5.5, 7 and 7 post-GK years, respectively. We also experienced five patients (9.4%) in whom, despite remaining asymptomatic to date, radiation-related adverse effects were seen on neuro-imaging: middle cerebral artery stenosis at 3 post-GK years in one patient; dural arteriovenous fistula at 7 post GK-years in one; delayed cyst formation in two, at 5 and 10 post-GK years; and a small cavitation at 9 post-GK years. CONCLUSION: Long-term follow-up, particularly with neuro-imaging modalities, is essential even after the "treatment goal" has been attained.
Authors: Antonio Nicolato; Roberto Foroni; Andrea Seghedoni; Valentina Martines; Francesco Lupidi; Piergiuseppe Zampieri; Marco F Sandri; Umberto Ricci; Carlo Mazza; Alberto Beltramello; Massimo Gerosa; Albino Bricolo Journal: Childs Nerv Syst Date: 2005-01-15 Impact factor: 1.475
Authors: Vera Parkhutik; Aida Lago; Fernando Aparici; Juan Francisco Vazquez; Jose Ignacio Tembl; Lourdes Guillen; Esperanza Mainar; Victor Vazquez Journal: Neuroradiology Date: 2012-11-27 Impact factor: 2.804
Authors: Myung Ji Kim; Kyung Won Chang; So Hee Park; Won Seok Chang; Jong Hee Chang; Jin Woo Chang; Hyun Ho Jung Journal: J Clin Med Date: 2021-05-19 Impact factor: 4.241