84 Cases of Cerebral Arteriovenous Malformations Subjected to Linac Stereotactic Radiosurgery: Initial Experience from Madras, India

Abstract Arteriovenous malformations of the brain are a considerable source of morbidity and mortality for patients who harbor them. Although our understanding of this disease has improved, it remains in evolution. Advances in our ability to treat these malformations and the modes by which we address them have also improved substantially. However, the variety of patient clinical and disease scenarios often leads us into challenging and complex management algorithms as we balance the risks of treatment against the natural history of the disease. The goal of this article is to provide a focused review of the natural history of cerebral arteriovenous malformations, to examine the role of stereotactic radiosurgery, to discuss the role of endovascular therapy as it relates to stereotactic radiosurgery, and to look toward future advances.

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Clinical and pathological changes in cerebral arteriovenous malformations after stereotactic radiosurgery failure

Chinese Medical Journal ◽

10.1097/00029330-200806020-00006 ◽

2008 ◽

Vol 121 (12) ◽

pp. 1076-1079 ◽

Cited By ~ 3

Author(s):

Wei-ming LIU ◽

Xun YE ◽

Yuan-li ZHAO ◽

Shuo WANG ◽

Ji-zong ZHAO

Keyword(s):

Stereotactic Radiosurgery ◽

Arteriovenous Malformations ◽

Pathological Changes ◽

Cerebral Arteriovenous Malformations

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Seizure outcomes following radiosurgery for cerebral arteriovenous malformations

Neurosurgical FOCUS ◽

10.3171/2014.6.focus1454 ◽

2014 ◽

Vol 37 (3) ◽

pp. E17 ◽

Cited By ~ 64

Author(s):

Ching-Jen Chen ◽

Srinivas Chivukula ◽

Dale Ding ◽

Robert M. Starke ◽

Cheng-Chia Lee ◽

...

Keyword(s):

Stereotactic Radiosurgery ◽

Arteriovenous Malformations ◽

Seizure Control ◽

Case Series ◽

Outcome Data ◽

Seizure Outcome ◽

Seizure Freedom ◽

Cerebral Arteriovenous Malformations ◽

Control Seizure ◽

Free Status

Object Seizures are a common presentation of cerebral arteriovenous malformations (AVMs). The authors evaluated the efficacy of stereotactic radiosurgery (SRS) for the management of seizures associated with AVMs and identified factors influencing seizure outcomes following SRS for AVMs. Methods A systematic literature review was performed using PubMed. Studies selected for review were published in English, included at least 5 patients with both cerebral AVMs and presenting seizures treated with SRS, and provided post-SRS outcome data regarding obliteration of AVMs and/or seizures. Demographic, radiosurgical, radiological, and seizure outcome data were extracted and analyzed. All seizure outcomes were categorized as follows: 1) seizure free, 2) seizure improvement, 3) seizure unchanged, and 4) seizure worsened. Systematic statistical analysis was conducted to assess the effect of post-SRS AVM obliteration on seizure outcome. Results Nineteen case series with a total of 3971 AVM patients were included for analysis. Of these, 28% of patients presented with seizures, and data for 997 patients with available seizure outcome data who met the inclusion criteria were evaluated. Of these, 437 (43.8%) patients achieved seizure-free status after SRS, and 530 (68.7%) of 771 patients with available data achieved seizure control (seizure freedom or seizure improvement) following SRS. Factors associated with improved seizure outcomes following SRS for AVMs were analyzed in 9 studies. Seizure-free status was achieved in 82% and 41.0% of patients with complete and incomplete AVM obliteration, respectively. Complete AVM obliteration offered superior seizure-free rates compared with incomplete AVM obliteration (OR 6.13; 95% CI 2.16–17.44; p = 0.0007). Conclusions Stereotactic radiosurgery offers favorable seizure outcomes for AVM patients presenting with seizures. Improved seizure control is significantly more likely with complete AVM obliteration.

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