Search

Background Gamma Knife radiosurgery (GKRS) in the treatment of arteriovenous malformations (AVMs) is still controversially discussed. Objective To present long-term follow-up data on patients after Gamma Knife radiosurgery for cerebral AVMs. Methods Overall, 516 patients received radiosurgery for cerebral AVMs between 1992 and 2018 at our department, of whom 265 received radiosurgery alone and 207 were treated with a combined endovascular-radiosurgical approach. Moreover, 45 patients were treated with a volume-staged approach. Two eras were analyzed, the pre-modern era between 1992 and 2002 and the modern era thereafter. Results In GKRS-only treated patients, median time to nidus occlusion was 3.8 years. Spetzler--Ponce (SP) class was a significant predictor for time to obliteration in the whole sample. Median time to obliteration for the combined treatment group was 6.5 years. Patients in the pre-modern era had a significantly higher obliteration rate than those treated in the modern era. Overall, the calculated yearly hemorrhage risk in the observation period after first GKRS was 1.3%. Permanent post-radiosurgical complications occurred in 4.9% of cases but did not differ between the treatment groups or treatment eras. The obliteration rate was significantly lower and the hemorrhage rate was higher in volume-staged treated patients than in conventionally treated patients. Conclusion GKRS is an effective treatment option for SP class A and B cerebral AVMs. After combined endovascular-radiosurgical treatment, the outcome of selected SP class C AVMs aligns with that of SP class B lesions. Both the combined therapy and radiosurgery alone constitute sound methods for treatment of cerebral AVMs. [ABSTRACT FROM AUTHOR]

Objective: We compare the clinical and radiological outcome in patients with cerebral cavernous malformations (CCMs), treated with Gamma Knife radiosurgery to the natural course / conservative management. Methods: A retrospective analysis of all patients with CCMs, who had been treated conservatively or radiosurgically between 1980 and 2019 at the Medical University of Vienna, was performed. Results: In total, 102 patients were treated radiosurgically, while 536 patients were managed conservatively. We present clinical and radiological data. Clinical data, hemorrhage risk and clinical outcome of the radiosurgery group is compared to the natural course / conservative management. Conclusion: Gamma Knife radiosurgery represents a safe and effective treatment option for CCM. [ABSTRACT FROM AUTHOR]