J Korean Soc Ther Radiol Oncol.  2001 Mar;19(1):1-9.

Clinical Experience of LINAC-based Stereotactic Radiosurgery for Angiographically Occult Vascular Malformations

• Kim DY
• Ahn YC
• Lee JI
• Nam DH
• Lim DH
• Lee JE
• Yeo IJ
• Huh SJ
• Noh YJ
• Shin SS
• Hong SC
• Kim JH

Abstract

PURPOSE: To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM).
MATERIALS AND METHODS
Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were performed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter.
RESULTS
With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMs at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased T2 signal intensity.
CONCLUSION
SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

Keyword

Stereotactic radiosurgery; Angiographically occult vascular malformation; Rebleeding; Complication

MeSH Terms

Brain
Edema
Follow-Up Studies
Hemorrhage
Humans
Incidence
Magnetic Resonance Imaging
Necrosis
Neurologic Manifestations
Prescriptions
Radiosurgery*
Vascular Malformations*