Gamma Knife Radiosurgery in Cerebral Arteriovenous Malformation

Choi, Joon Sik; Kim, Moo Seong; Jung, Yong Tae; Kim, Soo Chun; Sim, Jae Hong

Abstract

Between October 1994 and October 1996, 28 cerebral arteriovenous malformation(AVM) patients were treated with Gamma Knife radiosurgery at Pusan Paik Hospital, Inje University. Their ages ranged from 13 to 64(mean 32.9) years, and ten cases were followed up over one year. To reduce the size of AVM before surgery, intravascular embolization was performed in one case and surgical procedures(subtotal and partial resection)in three. All cases were symptomatic: seven had hemorrhage, Two involved seizures, and one suffered from headaches. The AVMs were located in the basal ganglia in four cases, were parietal in three, temporal in two and one was located in the frontal lobe. The volume of the AVM was more than 10cc in three cases, 4-10cc in one case and less then 4cc in six cases. After Gamma Knife radiotherapy, complete obliteration was confirmed by follow-up angiography or MRA in three cases, and partial obliteration in six; two of these six developed ICH at 6 and 10 months after GKS. In both, the nidus was located at the periventricular area, and the volume was more than 10cc. Maximum doses were 10,8-2.5Gy. The clinical results were that eight cases showed no change, one recovered but showed mild neurological deficit, and one died.