The Incidence of Imaging Abnormalities after Stereotactic Radiosurgery for Cerebral Arteriovenous and Cavernous Malformations

2009 ◽  
pp. 187-190 ◽  
Author(s):  
Sławomir Blamek ◽  
Marek Boba ◽  
Dawid Larysz ◽  
Adam Rudnik ◽  
Kornelia Ficek ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Malformations

Stereotactic Radiosurgery for Cavernous Malformations: Kjellberg's Experience with Proton Beam Therapy in 98 Cases at the Harvard Cyclotron

Neurosurgery ◽  
1999 ◽  
Vol 44 (2) ◽  
pp. 424-424 ◽  
Author(s):  
Randall W. Porter ◽  
Paul W. Detwiler ◽  
Patrick P. Han ◽  
Robert F. Spetzler
Keyword(s):  
Stereotactic Radiosurgery ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Cavernous Malformations

Long-term Results after Stereotactic Radiosurgery for Patients with Cavernous Malformations

Neurosurgery ◽  
2002 ◽  
Vol 50 (6) ◽  
pp. 1190-1198 ◽  
Author(s):  
Toshinori Hasegawa ◽  
James McInerney ◽  
Douglas Kondziolka ◽  
John Y.K. Lee ◽  
John C. Flickinger ◽  
...  
Keyword(s):  
High Risk ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife Radiosurgery ◽  
Long Term Results ◽  
Major Hemorrhage ◽  
Cavernous Malformations ◽  
Before And After ◽  
Risk Of Hemorrhage

Abstract OBJECTIVE Stereotactic radiosurgery has been used for patients with high-risk cavernous malformations of the brain. We performed radiosurgery for patients with symptomatic, imaging-confirmed hemorrhages for which resection was believed to be associated with high risk. This study examines the long-term hemorrhage rate after radiosurgery. METHODS We reviewed data obtained before and after gamma knife radiosurgery on 82 patients treated between 1987 and 2000. Most patients had multiple hemorrhages from brainstem or diencephalic cavernous malformations. Follow-up data were examined to identify hemorrhages, and an overall hemorrhage rate was calculated. RESULTS Observation before treatment averaged 4.33 years (range, 0.17–18 yr) for a total of 354 patient-years. During this period, 202 hemorrhages were observed, for an annual hemorrhage rate of 33.9%, excluding the first hemorrhage. Temporal clustering of hemorrhages was not significant. After radiosurgery, patient follow-up averaged 5 years (range, 0.42–12.08 yr), for a total of 401 patient-years. During this period, 19 hemorrhages were identified, 17 in the first 2 years posttreatment and 2 after 2 years. The annual hemorrhage rate was 12.3% per year for the first 2 years after radiosurgery, followed by 0.76% per year from Years 2 to 12. Eleven patients had new neurological symptoms without hemorrhage after radiosurgery (13.4%). The symptoms were minor in six of these patients and temporary in five. CONCLUSION Radiosurgery confers a reduction in the risk of hemorrhage for high-risk cavernous malformations. Risk reduction, although in evidence during initial follow-up, is most pronounced after 2 years. Given the difficulty of identifying high-risk patients, treatment after one major hemorrhage should be considered in selected younger patients. Such a strategy warrants further investigation.

Stereotactic radiosurgery of brainstem cavernous malformations: a systematic review and meta-analysis

2014 ◽  
Vol 120 (4) ◽  
pp. 982-987 ◽  
Author(s):  
Xin-Yu Lu ◽  
Hui Sun ◽  
Jian-Guo Xu ◽  
Qiao-Yu Li
Keyword(s):  
Systematic Review ◽  
Stereotactic Radiosurgery ◽  
Meta Analysis ◽  
Analysis Data ◽  
Scientific Publication ◽  
Neurological Deficits ◽  
Published Data ◽  
Cavernous Malformations ◽  
Before And After ◽  
High Operative Risk

Object Over the last two decades, stereotactic radiosurgery (SRS) has arisen as a promising approach in the management of brainstem cavernous malformations (CMs). In the present study, the authors report a systematic review and meta-analysis of the available published data regarding the radiosurgical management of brainstem CMs. Methods To identify eligible studies, systematic searches for brainstem CMs treated with SRS were conducted in major scientific publication databases. The search yielded 5 studies, which were included in the meta-analysis. Data from 178 patients with brainstem CMs were extracted. Hemorrhage rates before and after SRS were calculated, a meta-analysis was performed, and the risk ratio (RR) was determined. Results Four studies showed a statically significant reduction in the annual hemorrhage rate after SRS. The overall RR was 0.161 (95% CI 0.052–0.493; p = 0.001), and 21 patients (11.8%) had transient or permanent neurological deficits. Conclusions The present meta-analysis for the radiosurgical management of brainstem CMs shows that SRS can decrease the rate of repeat hemorrhage and has a low rate of adverse effects compared with surgery. The authors suggest that SRS may be considered as an alternative treatment for brainstem CMs that are inoperable or have a high operative risk.

scholarly journals Stereotactic radiosurgery for cerebral cavernous malformations

Neurology ◽  
2019 ◽  
Vol 93 (21) ◽  
pp. e1971-e1979 ◽  
Author(s):  
Michiel H.F. Poorthuis ◽  
Leon A. Rinkel ◽  
Simon Lammy ◽  
Rustam Al-Shahi Salman
Keyword(s):  
Stereotactic Radiosurgery ◽  
Clinical Outcomes ◽  
Conservative Management ◽  
Treatment Strategies ◽  
Cerebral Cavernous Malformations ◽  
Cavernous Malformations ◽  
Ovid Medline ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Patient Groups ◽  
Calculated Probability

ObjectiveThe efficacy of stereotactic radiosurgery (SRS) for the treatment of cerebral cavernous malformations (CCMs) is uncertain, so we set out to quantify clinical outcomes after SRS for CCM and compare them to microsurgical excision or conservative management.MethodsWe searched Ovid Medline and Ovid EMBASE from inception until June 1, 2018, for peer-reviewed publications describing clinical outcomes after SRS for ≥10 people with CCM in cohorts with or without a comparison group treated with neurosurgical excision or conservative management. Two reviewers independently extracted data from the included studies to quantify cohort characteristics and the incidence of the primary outcome (death attributable to CCM or its treatment) and secondary outcomes (incident nonfatal symptomatic intracerebral hemorrhage [ICH] and incident nonhemorrhagic persistent focal neurologic deficit [FND]). We assessed whether comparative studies showed a dramatic association (meaning the conventionally calculated probability comparing 2 differently managed patient groups from the same population was <0.01 with a rate ratio greater than 10).ResultsWe included 30 cohort studies involving a total of 1,576 patients undergoing SRS for CCM. Four nonrandomized studies compared SRS to other treatment strategies, but did not demonstrate dramatic associations. During a median follow-up of 48 (interquartile range 35–62) months after SRS, the annual incidences (95% confidence interval) of outcomes were death 0.18% (0.10–0.31), ICH 2.40% (2.05–2.80), FND 0.71% (0.53–0.96), and the composite of death, ICH, or FND 3.63% (3.17–4.16). Outcomes did not differ by CCM location or type of SRS.ConclusionAfter SRS for CCM, the annual incidences of death, ICH, and FND are <5% and seem comparable to outcomes without SRS. A randomized trial of SRS for CCM is needed.

710 Long-term Follow-up of Patients with Cavernous Malformations Treated by Stereotactic Radiosurgery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 509
Author(s):  
Toshinori Hasegawa MD ◽  
James McInerney MD ◽  
John Y.K. Lee ◽  
Douglas Kondziolka MD ◽  
John Flickinger MD ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Malformations ◽  
Long Term Follow Up

Defining Long-Term Clinical Outcomes and Risks of Stereotactic Radiosurgery for Brainstem Cavernous Malformations

2019 ◽  
Vol 124 ◽  
pp. e58-e64 ◽  
Author(s):  
Rachel Jacobs ◽  
Hideyuki Kano ◽  
Bradley A. Gross ◽  
Ajay Niranjan ◽  
Edward A. Monaco ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Clinical Outcomes ◽  
Cavernous Malformations

Stereotactic Radiosurgery of Intracranial Cavernous Malformations

2013 ◽  
Vol 24 (4) ◽  
pp. 575-589 ◽  
Author(s):  
Gábor Nagy ◽  
Andras A. Kemeny
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Malformations
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