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Results of surgical treatment after Gamma Knife radiosurgery for cerebral arteriovenous malformations: patient series. | LitMetric

AI Article Synopsis

  • Gamma Knife radiosurgery (GKRS) is an effective treatment for cerebral arteriovenous malformations (AVMs), but there's a risk of bleeding that can lead to the need for surgical removal.
  • A study analyzed twelve patients who underwent AVM removal after GKRS, noting that most had improved or reduced symptoms and no complications from the surgery.
  • The findings suggest that using GKRS as an initial treatment could enhance outcomes and pave the way for more comprehensive therapies in the future.

Article Abstract

Background: Gamma Knife radiosurgery (GKRS) is a safe and effective treatment, but it has a risk of bleeding. Herein, the authors describe their experience with some patients who required surgical removal of cerebral arteriovenous malformations (AVMs) located mainly in eloquent areas of the brain after GKRS, and they consider the advantages of surgical removal after GKRS.

Observations: Twelve patients who had undergone surgical removal of AVMs after GKRS at Tokyo Women's Medical University between April 2013 and July 2019 were selected for analysis. All participants underwent GKRS as first-line therapy for AVMs located in an eloquent region or if requested by the patient. Complete obliteration was achieved in 7 patients, and the size of the nidus decreased in 3 patients during the follow-up period. The Spetzler-Martin grade decreased in 11 patients. Three patients experienced symptomatic intracerebral hemorrhage before and after confirmation of complete obliteration of the nidus via GKRS, and 7 patients experienced some neurological deficits because of an encapsulated expanding hematoma. All patients underwent resection of the nidus without complications. The preoperative neurological deficits improved in 6 patients and remained unchanged in 6 patients.

Lessons: This report indicates that performing GKRS before surgery may be useful for future multimodal therapy.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245776PMC
http://dx.doi.org/10.3171/CASE21181DOI Listing

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