2017 Volume 45 Issue 4 Pages 243-250
To evaluate the long-term outcomes of stereotactic radiosurgery (SRS) for cerebral arteriovenous malformation (AVM) in pediatric patients, we retrospectively analyzed our treatment data of 117 consecutive patients aged ≤18 years who underwent gamma knife radiosurgery (GKRS) for AVM from 1990-2013. Eighty-five patients (73%) experienced hemorrhage before GKRS. The median follow up period was 104 months (range, 14-282 months). Actuarial rates of nidus obliteration after a single session of GKRS were 61% and 82% at 3 and 5 years, respectively. Nidus volume ≤2 cm3 was significantly associated with obliteration in univariate and multivariate analyses. Only one patient died because of massive hemorrhage. Some permanent deficits were observed in eight patients (6.8%) during the follow up periods. Eloquent location was the only statistically significant predictive factor for permanent deficits. Considering the effectiveness and less invasive nature of the procedure, GKRS could be a first-line therapeutic option for AVMs in children and adolescents. Long-term follow up is recommended for possible radiation-induced delayed complications as well as nidus recurrence.
