Int J Radiat Oncol Biol Phys
September 2003
Purpose: To evaluate the efficacy and outcome of Linac radiosurgery (RS) as treatment of cerebral arteriovenous malformations (cAVM) in a series of 57 children.
Methods And Materials: Between 1984 and 2000, we used Linac radiosurgery to treat 792 patients with cAVM. This series included 57 children (7.
Int J Radiat Oncol Biol Phys
June 2003
Purpose: To evaluate repeat radiosurgery (RS2) for cerebral arteriovenous malformations (AVMs) after failure of initial radiosurgery (RS1).
Methods And Materials: Between 1986 and 2000, 41 patients underwent RS2. Nine patients were not assessable: seven had insufficient follow-up (RS2 in 1999 and 2000) and two had no recent control angiography data.
We have evaluated our therapeutic strategy through the results of modalities used alone or in association. Should the place of each modality be modified? What could be the influence of the first consulting physician? We feel at the present time that small cerebral arteriovenous malformations could be treated by radiosurgery, surgery and embolization according to their characteristics and location. For middle size and some large cerebral arteriovenous malformations, we consider that embolization and/or surgery are adjuvant modalities, specifically when the cerebral arteriovenous malformation is located in an eloquent area.
View Article and Find Full Text PDFBackground And Purpose: Purposes of this study are to describe different parenchymal changes seen after radiosurgery of cerebral arteriovenous malformations and the clinical symptoms which can be associated, and risk factors correlated with them.
Patients: and method. From the whole population of 705 patients with a cerebral arteriovenous malformations treated by radiosurgery between 1984 and 1998, clinical from 615 patients and post radiosurgery MRI data from 367 patients were reviewed.
The purpose of this study is to evaluate the response of headaches associated with cerebral arteriovenous malformations following radiosurgery and determine the factors that are associated with a positive outcome. From our series of 700 patients whose cAVM was treated by radiosurgery, this study includes 109 patients (48 males, 61 females) with a mean age of 32 when radiosurgery was performed. Headaches resolved in 37 patients (53.
View Article and Find Full Text PDFThe goal of this study is to evaluate the response of epileptic seizures associated with cerebral arteriovenous malformations following radiosurgery and determine the factors associated with a positive outcome. The series included 210 patients (123 men, 87 women) with a mean age of 33. One hundred seventy three patients out of 210 were controlled after radiosurgery.
View Article and Find Full Text PDFBackground And Purpose: Obliteration is progressive after radiosurgery of cerebral arteriovenous malformations. Thus the hemorrhage risk still remains until obliteration. Purposes of this study are to appreciate severity of post-radiosurgery hemorrhages, actuarial risk of hemorrhage and parameters associated with it.
View Article and Find Full Text PDFRisks of bleeding from partially or unobliterated cerebral arteriovenous malformations remain unchanged. A complementary treatment should be indicated after radiosurgery. In this brief review the following data are discussed: the reasons of second treatment, imaging follow-up of cerebral arteriovenous malformations after radiosurgery, types of cerebral arteriovenous malformations to be treated, timing and therapeutic modalities.
View Article and Find Full Text PDFBackground And Purpose: Between 20 to 50% of cerebral arteriovenous malformations treated with radiosurgery (RS) fail to obliterate 2 to 5 years after irradiation. Patients are not protected against the risks leading to treatment. Two therapeutic options can be used to eradicate the persisting nidus: micro-surgery and a second irradiation.
View Article and Find Full Text PDFThe aim of this paper is to analyze retrospectively the reasons for the failure in cerebral arteriovenous malformations radiosurgery. Several factors are evoked and discussed mainly: inaccurate target, intentional partial irradiation, repermeabilization of a previously embolized cerebral arteriovenous malformation. The results suggest the necessity of a complete irradiation of the nidus.
View Article and Find Full Text PDFBackground And Purpose: Radiosurgery has been used in a few cases of cerebral arteriovenous malformations in children. From data of our series and from literature, we tried to determine the place of this therapeutic modality for treatment of pediatric cAVMs.
Patients And Method: From the whole series of 705 patients treated by radiosurgery between January 84 and December 1998, 55 were under 15 years of age.
Background And Purpose: Treatment of large cerebral arteriovenous malformations is a challenge for embolization, surgery and radiosurgery too. The purposes of this study is to review results of RS for these large cerebral arteriovenous malformations and to study recent methods which can allow to improve results.
Patients: and method.
Purpose: Cerebral arteriovenous malformations surrounded by cerebrospinal fluid seemed to exhibit worse response to radiosurgery than others. We searched to verify if this is was true and to find causes.
Material: and methods.
Background And Purpose: After a review of the main radiosurgical published series, to evaluate our own series of 705 patients with cerebral arteriovenous malformations treated by radiosurgery alone or in combination with embolization or surgery.
Patients: and method. From January 1984 to December 1998, 705 patients were treated by a multidisciplinary team including neurosurgeons, neuroradiologists, radiophysicians and radiotherapists.
We have been using the stereotactic methodology of Talairach for Linac radiosurgery of cerebral arteriovenous malformations since 1984, and updated it with addition of CT and MR images into the stereotactic space. The target remains defined, as in most other centers, by stereotactic angiography. However, tridimensional configuration of cerebral arteriovenous malformations is better defined using MR or CT-angiography.
View Article and Find Full Text PDFBackground And Purpose: Description and critical review of our procedure of definition of the target of irradiation of a cerebral arteriovenous malformations.
Patients: and method. Fixation of the stereotactic frame, performing of stereotactic angiography and CT scanner were described, and the target including nidus and venous collectors of the a cerebral arteriovenous malformations defined.
Progressive neurological deficits are uncommonly associated with cerebral arteriovenous malformations. We present 25 cases (3.54%) from our series of 705 patients treated by radiosurgery.
View Article and Find Full Text PDFBackground: and purposes. The purpose of this study was to identify the specific characteristics of headaches associated with cerebral arteriovenous malformations in order to differentiate them from other known entities of headaches such as migraine, cluster headache, and trigeminal neuralgia. This differentiation allows an early diagnosis of cAVM and a treatment to be administrated before any cerebral hemorrhage.
View Article and Find Full Text PDFPurposes: The purpose of this study is to analyze the characteristics of epileptic seizures associated with cerebral arteriovenous malformations treated by radiosurgery.
Patients And Methods: Seven hundred and two patients are studied (406 men, 296 women) with a mean age of 33 when radiosurgery was performed. 210 patients had epileptic seizures; those seizures either uniquely revealed the arteriovenous malformation or were associated with other clinical signs.
Background And Purpose: Potential severity of hemorrhage often leads to treat a cerebral arteriovenous malformation. Consequences can be very various and serious. Our first purpose is to define the different types of hemorrhage.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
March 2000
Purpose: To present the SALT group results using Linac radiosurgery (RS) for AVM in 169 evaluable patients treated from January 1990 thru December 1993.
Methods And Materials: Median age was 33 years (range 6-68 years). Irradiation was the only treatment in 55% patients.
AJNR Am J Neuroradiol
March 1999
Background And Purpose: Radiosurgical treatment of arteriovenous malformations (AVMs) has slow and progressive vasoocclusive effects. We sought to determine if early posttherapeutic angiography provides relevant information for the management of radiosurgically treated AVMs.
Methods: Between 1990 and 1993, the progress of 138 of 197 cerebral AVMs treated by linear accelerator (Linac) was regularly followed by angiographic study.
Since 1984, the neurosurgical team of Sainte-Anne Hospital in Paris has taken in charge almost 750 patients for linear accelerator radiosurgery. But only a small percentage of them were harbouring a pituitary tumor. That is why the present paper is based mostly on literature data.
View Article and Find Full Text PDFBackground And Purpose: Therapeutic strategy for the cerebral arteriovenous malformations (cAVM) is mainly based on the assessment of hemorrhage risk. This risk is estimated between 2 and 4% according to various series. However, this is a collective risk projected upon a given population.
View Article and Find Full Text PDFNew imaging modalities permit detailed knowledge of the anatomy of cerebral arteriovenous malformations. Magnetic resonance imaging (MRI) provides morphological data, size and topography of the nidus, anatomic relationship, as well as dynamic information particularly with the use of MR angiography. Selective and hyperselective cerebral angiography provide information about the angioarchitecture and search for associated vascular abnormalities such as aneurysms.
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