In:
Cerebrovascular Diseases, S. Karger AG, Vol. 50, No. 2 ( 2021), p. 222-230
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 This study was performed to investigate clinical characteristics and outcome after gamma knife radiosurgery (GKS) in patients with incidental, symptomatic unruptured, or ruptured arteriovenous malformations (AVMs). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 491 patients with brain AVMs treated with GKS from June 2002 to September 2017 were retrospectively reviewed. All patients were classified into the incidental ( 〈 i 〉 n 〈 /i 〉 = 105), symptomatic unruptured ( 〈 i 〉 n 〈 /i 〉 = 216), or ruptured AVM ( 〈 i 〉 n 〈 /i 〉 = 170) groups. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The mean age at diagnosis of incidental, symptomatic unruptured, and ruptured AVMs was 40.3, 36.7, and 27.6 years, respectively. The mean nidus volume was 3.9, 5.7, and 2.4 cm 〈 sup 〉 3 〈 /sup 〉 , respectively. Deep venous drainage was identified in 34, 54, and 76% patients, respectively. There were no significant differences in obliteration rates after GKS between the 3 groups (64.8, 61.1, and 65.9%, respectively) after a mean follow-up period of 60.5 months; however, patients with incidental AVM had a significantly lower post-GKS hemorrhage rate than patients with symptomatic unruptured or ruptured AVMs (annual hemorrhage rate of 1.07, 2.87, and 2.69%; 〈 i 〉 p 〈 /i 〉 = 0.028 and 〈 i 〉 p 〈 /i 〉 = 0.049, respectively). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 There is a significant difference in clinical and anatomical characteristics between incidental, symptomatic unruptured, and ruptured AVMs. The obliteration rate after GKS is not significantly different between the 3 groups. Meanwhile, an older age at diagnosis and lower hemorrhage rate after GKS in incidental AVMs suggest that they have a more indolent natural course with a lower life-long risk of hemorrhage.
Type of Medium:
Online Resource
ISSN:
1015-9770
,
1421-9786
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
1482069-9
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