Stereotactic radiosurgery is a safe and effective means of treating many children with arteriovenous malformations, according to a presentation at the American Association of Neurological Surgeons (AANS) annual meeting held recently in Philadelphia.
Over a 17-year period, researchers from the Mayo Clinic in Rochester, MN, found an overall 63% success rate for using the Gamma Knife (Accuray, Sunnyvale, CA) to treat patients with this rare malformation. Intracranial arteriovenous malformations are abnormal tangles of blood vessels in the brain, which occur in less than 0.2 of 1% of the population.
Neurosurgeon Dr. Bruce Pollock and colleagues collected and analyzed data from 48 patients younger than 18 who had this surgery between 1990 and 2007. Twenty-seven patients, or 57%, had a brain hemorrhage before the surgery. Fifteen patients had malformations in deep locations.
After the initial radiosurgery, more than half the patients had the malformation obliterated. Twelve patients required repeat stereotactic radiosurgery, which obliterated the malformation in five. The overall obliteration rate was 63% for the 48 children.
Three patients had radiation-related deficits, but no patients experienced arteriovenous malformation bleeding, neurocognitive decline, or radiation-induced tumor after the procedure. Based on 20 years of clinical outcomes, Pollock said that the risks commonly associated with radiation exposure in children and adolescents were extremely low, and in the opinion of the Mayo Clinic, Gamma Knife stereotactic radiosurgery was a safe treatment.
Related Reading
Radiosurgery for cerebral arteriovenous malformations provides rapid results, January 13, 2005
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