scholarly journals Hemorrhage from Arteriovenous Malformation Following Gamma Knife Radiosurgery: Pathophysiology of Rupture Early in the Latency Period

10.5772/31481 ◽  
2011 ◽  
Author(s):  
Juanita M. ◽  
James G. ◽  
Robert Goodki
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Latency Period

scholarly journals Gamma Knife Radiosurgery Followed by Flow-Reductive Embolization for Ruptured Arteriovenous Malformation

2020 ◽  
Vol 9 (5) ◽  
pp. 1318
Author(s):  
Myung Ji Kim ◽  
So Hee Park ◽  
Keun Young Park ◽  
Hyun Ho Jung ◽  
Jong Hee Chang ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Predictive Factors ◽  
Gamma Knife Radiosurgery ◽  
Latency Period ◽  
Cyst Formation ◽  
Complication Rates ◽  
Major Drawback ◽  
Significant Difference ◽  
Complete Obliteration

Background: Aggressive treatment to achieve complete obliteration of brain arteriovenous malformation (AVM) is necessary in patients with a recent history of hemorrhage. The major drawback of Gamma knife radiosurgery (GKRS) alone for AVM is risk of bleeding during the latent period until the AVM occludes. At our center, patients who present with ruptured AVMs are frequently offered GKRS followed by embolization. The goal of this study was to compare outcomes of embolization for patients who have previously undergone GKRS for ruptured AVMs. Methods: A database including 150 GKRS for ruptured AVMs between November 2008 and October 2017 was reviewed. The embolized group was selected by including AVMs with post-GKRS embolization. The non-embolized group was defined as AVMs treated by GKRS alone. Outcomes including obliteration rate, incidence of repeat hemorrhage, and delayed cyst formation were compared between two groups. The predictive factors related to AVM obliteration and complications were analyzed. Results: The study consisted of 81 patients in the non-embolized group and 17 patients in the embolized group. Statistically significant differences were detected between the two groups with respect to age, Pollock-Flickinger score, Spetzler-Martin (SM) grade, eloquence of adjacent brain, and presence of aneurysms. The embolized group included more AVMs with larger median nidus volume. The predictive factors for the obliteration of ruptured AVMs were nidus volume, SM grade, Virginia Radiosurgery AVM Scale (VRAS), and Pollock-Flickinger score and for the subsequent hemorrhage were marginal dose, nidus volume, SM grade, VRAS, and Pollock-Flickinger score. The obliteration rates and complication rates after GKRS between groups were not significantly different. However, this study demonstrated statistically significant difference in the cumulative incidence of obliteration in AVMs with SM grade III and IV (p = 0.037). Conclusion: Although the current study demonstrated similar results in patients who underwent GKRS with and without embolization, the embolized group included more AVMs with larger nidus volume, higher SM grade, Pollock-Flickinger score, and aneurysm, which have a lower chance of obliteration and a higher probability of repeat hemorrhage. GKRS followed by embolization appears to be a beneficial approach for the treatment of ruptured AVMs that are at risk for obliteration failure and repeat hemorrhage during the latency period after single-session GKRS alone. Further studies involving a larger number of cases and continuous follow-up are necessary to confirm our conclusions.

scholarly journals Bibliometric analysis of the top-100 most cited articles on the radiosurgical management of cerebral arteriovenous malformation

2020 ◽  
Vol 11 ◽  
pp. 477
Author(s):  
Ali Alkhabiry ◽  
Othman T. Almutairi ◽  
Turki Elarjani ◽  
Mohammed Bafaquh ◽  
Hossam Alassaf ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
The United States ◽  
Cerebral Arteriovenous Malformations ◽  
Exclusion Criteria ◽  
Scholarly Impact ◽  
English Articles ◽  
Conference Papers ◽  
Specific Search

Background: Radiosurgery is an effective, alternative treatment modality in managing patients with cerebral arteriovenous malformations (AVMs). The present study aims to highlight the scholarly impact of the top-100 most cited articles on the radiosurgical management of AVMs. Methods: A title-specific search using the keyword “arteriovenous malformation” was conducted in the Scopus database. The outcome of the search was rearranged based on the citations count. Articles were categorized into four entities; clinical, gamma knife radiosurgery, linear accelerator (LINAC) radiosurgery, and proton beam radiosurgery. The exclusion criteria were applied to spinal or non-intracranial AVM, conference papers, non-English articles predominantly discussing the endovascular or microsurgical management. Results: The top-100 articles on the radiosurgical management of AVM were published between 1972 and 2016. Approximately one-third of the publications were produced between 1995 and 2000. The average citations per year for all papers were seven. The most-studied entity was pertinent to the clinical application of gamma knife radiosurgery in AVM (68%). The United States was the most active country in studying the radiosurgical application in AVM. The Journal of Neurosurgery published approximately one-third of the most-cited articles in the list. The top-3 most contributing authors, publishing 80% of articles in the list, were Lunsford et al. Conclusion: The radiosurgical management of AVMs evolved significantly throughout the years. Identifications of the publication trends facilitate the acquisition of evidence-based articles for authors investigating various radiosurgical techniques in the treatment of AVMs.

scholarly journals Endovascular Treatment Accounts for a Change in Brain Arteriovenous Malformation Natural History Risk

2010 ◽  
Vol 16 (2) ◽  
pp. 127-132 ◽  
Author(s):  
X. Lv ◽  
Z. Wu ◽  
C. Jiang ◽  
Y. Li ◽  
X. Yang ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Venous Drainage ◽  
Endovascular Embolization ◽  
Adjusted Relative Risk ◽  
Brain Arteriovenous Malformation ◽  
Kaplan Meier ◽  
Complete Obliteration ◽  
Risk Of Hemorrhage

This study estimated the risk and rates of intracranial hemorrhage (ICH) in patients harboring brain arteriovenous malformation (BAVM) after endovascular embolization. One hundred and forty-four consecutive patients with BAVM treated with endovascular embolization between 1998 and 2003 were retrospectively reviewed. The risk of ICH subsequent to endovascular embolization was studied using Kaplan-Meier curves. We reviewed 144 patients with BAVM treated with endovascular embolization. Two hundred and sixty-nine procedures were performed, 69 were performed with silk sutures, 18 with coils, 137 with NBCA and 36 with Onyx18. Twenty-three (16.0%) patients were treated with additional gamma-knife radiosurgery and one (0.7%) with additional surgical AVM excision. Complete obliteration of BAVMs was achieved in 20 patients (13.9%). During a mean follow-up of 5.9 years for the ICH group and 6.9 years for the non-ICH group, hemorrhages occurred in 11 (17.7%) of the ICH patients and in nine (11%) of the non-ICH group (p>0.1). The annual risk of hemorrhage was 3.0% and 1.6%, respectively. In the multivariate regression model, the adjusted relative risk (RR) for hemorrhage at initial presentation was 1.6 (95% CI 1.2–3.2; p>0.1). Deep venous drainage, male sex, age or AVM size were not significantly associated with subsequent hemorrhage. ICH and non-ICH groups did not differ in progression to subsequent ICH after endovascular embolization (log-rank X2 = 1.339, p>0.1) in survival analyses. The overall annual hemorrhage risk for all patients after endovascular embolization was 2.1%. Endovascular embolization alone or combined with gamma-knife radiosurgery or surgical treatment are able to decrease ICH occurrence compared to abstention.

Fatal glioblastoma after Gamma Knife radiosurgery for arteriovenous malformation in a child

2014 ◽  
Vol 21 (8) ◽  
pp. 1453-1455 ◽  
Author(s):  
Koichi Yoshida ◽  
Tomotsugu Ichikawa ◽  
Kazuhiko Kurozumi ◽  
Hiroyuki Yanai ◽  
Keisuke Onoda ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery

Long-term Effects of Gamma-knife Radiosurgery for Cerebral Arteriovenous Malformation

2008 ◽  
Vol 18 (2) ◽  
pp. 126-129
Author(s):  
Gang Zhao ◽  
Jun-chao Liang ◽  
Wei-min Wang ◽  
Hong-xun Wu ◽  
Lin Li ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Cerebral Arteriovenous Malformation ◽  
Long Term Effects

The Role of Gamma Knife Radiosurgery in Arteriovenous Malformation with Aneurysms

1999 ◽  
Vol 72 (1) ◽  
pp. 175-184 ◽  
Author(s):  
J. Vymazal ◽  
R. Liščagrave;k ◽  
J. Novotný ◽  
L. Janoušková ◽  
V. Vladyka
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery

scholarly journals Three Case Reports of Direct Surgery for Angiomatous Lesion Developing after Gamma Knife Radiosurgery for Arteriovenous Malformation

2011 ◽  
Vol 39 (5) ◽  
pp. 347-352 ◽  
Author(s):  
Takashi SHUTO ◽  
Shigeo MATSUNAGA ◽  
Jun SUENAGA ◽  
Tetsuya YOSHIZUMI ◽  
Shigeo INOMORI ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Case Reports ◽  
Gamma Knife Radiosurgery

scholarly journals Cerebral arteriovenous malformation radiosurgery after intracranial hemorrhage: A case report and literature review

2017 ◽  
Vol 70 (7-8) ◽  
pp. 241-244
Author(s):  
Bojan Jelaca ◽  
Tomislav Cigic ◽  
Vladimir Papic ◽  
Mladen Karan ◽  
Jagos Golubovic ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Intracranial Hemorrhage ◽  
Good Condition ◽  
Gamma Knife Radiosurgery ◽  
Treatment Modalities ◽  
Temporal Region ◽  
Surgical Morbidity

Introduction. Treatment of cerebral arteriovenous malformations is very challenging and controversial in spite of current recommendations. Surgery is recommended in patients with hemorrhagic stroke, but in patients with good neurological status, when symptoms improve rapidly, the risk of surgical morbidity may be much higher than the risk of rebleeding. Case report. We report a case of a patient with an intracranial hemorrhage due to a ruptured arteriovenous malformation located in the right temporal region of the brain. Because of angiographic and anatomical features of the arteriovenous malformation (deep location and deep venous drainage, but also small arteriovenous malformation nidus size), radiosurgery was the preferred treatment modality. The patient was treated conservatively in the acute stage, and the arteriovenous malformation was subsequently completely eradicated with gamma knife radiosurgery. During the 3-year imaging follow-up, no sings of rebleeding were found. Also, angiography demonstrated that the arteriovenous malformation was completely excluded from the cerebral circulation. The patient was in a good condition and presented without neurological deficits or seizures during the follow-up period. Conclusion. All treatment modalities carry a risk of neurological compromise, but gamma knife radiosurgery may be a good option, even in cases with hemorrhagic presentation. It needs to be mentioned that complete obliteration takes approximately 1 to 3 years after the treatment, and in some cases it cannot be obtained.

Impact of flow and angioarchitecture on brain arteriovenous malformation outcome after gamma knife radiosurgery: the role of hemodynamics and morphology in obliteration

2020 ◽  
Vol 162 (7) ◽  
pp. 1749-1757
Author(s):  
Pietro Panni ◽  
Alberto Luigi Gallotti ◽  
Carmen Rosaria Gigliotti ◽  
Ahmed Badry Shehata ◽  
Luigi Albano ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Brain Arteriovenous Malformation
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