Journal article
Clinical outcome of radiosurgery for cerebral arteriovenous malformations
Journal of neurosurgery, Vol.77(1), pp.1-8
07/1992
DOI: 10.3171/jns.1992.77.1.0001
PMID: 1607950
Abstract
The clinical outcomes are described for 247 consecutive cases of arteriovenous malformation (AVM) treated with the gamma knife between April, 1970, and December 31, 1983. Headache resolved in 65 (66.3%) of the 98 patients presenting with this symptom and improved in an additional nine (9.2%). Of 59 patients admitted with seizures, 11 (18.6%) became seizure-free without anticonvulsant medication and an additional 30 patients (50.8%) became seizure-free with anticonvulsant medication. Pre-existing neurological deficits improved or totally disappeared following radiosurgery in 56.7% of affected cases. This improvement presumably occurred within the frame of the natural history. The protective effect of the ionizing beams against hemorrhage in incompletely obliterated AVM's is analyzed. To assess the rate of rebleeding, probability estimates were calculated using both the person-year method and the Kaplan-Meier life table. With the person-year method the actual rebleed rate is not too different from the values observed in the natural history of the disease (2% to 3%/yr). Analysis by Kaplan-Meier life-table estimates demonstrated a risk of nearly 3.7%/yr until 60 months after radiosurgery. Five years following treatment, the life table ends in a plateau which could be interpreted as an indication of decrease in the risk of hemorrhage. However, long flat regions at the right end of the life table do not imply that the real risk of rebleeding is negligible unless a large number of patients have been followed well into or beyond the flat region.
Details
- Title: Subtitle
- Clinical outcome of radiosurgery for cerebral arteriovenous malformations
- Creators
- L Steiner - Department of Neurological Surgery, University of Virginia, CharlottesvilleC LindquistJ R AdlerJ C TornerW AlvesM Steiner
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.77(1), pp.1-8
- DOI
- 10.3171/jns.1992.77.1.0001
- PMID
- 1607950
- NLM abbreviation
- J Neurosurg
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Publisher
- United States
- Language
- English
- Date published
- 07/1992
- Academic Unit
- Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983995037502771
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