Gamma Knife Radiosurgery for Cerebellar Arteriovenous Malformation

Kim, Hoon; Kim, Moo Seong; Paeng, Seong Hwa; Jeong, Young Gyun; Pyo, Se Young; Jung, Yong Tae; Lee, Sun Il; Kim, Eung Kui; Jeong, Hae Woong

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2010;6(1):40-44.
Published online June 30, 2010.

Gamma Knife Radiosurgery for Cerebellar Arteriovenous Malformation

Hoon Kim, Moo Seong Kim, Seong Hwa Paeng, Young Gyun Jeong, Se Young Pyo, Yong Tae Jung, Sun Il Lee, Eung Kui Kim, Hae Woong Jeong

Department of Neurosurgery, Neurology, Diagnostic Radiology, Inje University Busan Paik Hospital, Busan, Korea

Abstract

Objective
Cerebellar arteriovenous malformation (AVM) is relative contraindication for surgery. The authors evaluated the result of treatment with GammaKnife radiosurgery (GKS) for this disease Materials & Methods: 402 AVMs were treated with GKS between 1994 and 2009, and 38 cerebellar AVMs were treated with GKS. Among these patients, 26 were evaluated to assess the effect of GKS. The male to female ratio was 15 : 11, with a mean age of 38.9 years (15-67). The mean volum e was 13.3 cc (0.55-32.6 cc) and the mean maximal dose was 33.3Gy with a mean margin dose of 15.6Gy. The follow up period ranged from 2-63 months (mean 23 months). The feeding arteries were PCA:21, SCA:1, PICA:2, AICA:2. PreGKS modalities consisted of 2 embolization, 1 GKS. There were two cases of double AVM (PCA & MCA feeder:both).
Results
There was total obliteration in 11 patients (42.3%), subtotal obliteration (from 50% to 70% reduction of nidus volume) in 5 patients (19.2%), partial obliteration(less than 50% reduction of nidus volume) in 9 patients (34.6%), and 1 patient (3.9%) showed no change. Bleeding occurred in 1 patient after GKS. There were no radiation-induced complications.
Conclusions
The result of this study suggests that GKS is a effective and safe treatment modality for cerebellar AVM. However, further study with increased cases should be needed.

Key Words: Cerebellar AVM, Gamma knife surgery, Obliteration.