gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Long-term results after gamma knife radiosurgery for patients with cavernous malformations

Langjähriges Follow-up nach Gamma-Knife Behandlung von Patienten mit zerebralen Cavernomen

Meeting Abstract

  • corresponding author I. Stavrou - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, AKH Wien
  • K. Kitz - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, AKH Wien
  • H. Ferraz-Leite - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, AKH Wien
  • H. G. Böcher-Schwarz - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, AKH Wien
  • E. Knosp - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, AKH Wien

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-16.08

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0263.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Stavrou et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The benefits of radiosurgery for cerebral cavernous malformations are difficult to assess because of the unclear natural history of this vascular lesion. Furthermore there is an inability to image accurately malformation vessels with the lack of an imaging technique defining “cure”. Up to date the only parameter that helps defining the efficiency of treatment methods is the patient’s clinical outcome. This study presents the long term results of 37 cases of cavernous malformations that underwent gamma knife radiosurgery.

Methods

41 patients presenting with cavernous malformations underwent radiosurgery between January 1994 and October. 2003. Four patients were lost for follow-up. Mean follow-up for the remaining 37 patients after radiosurgery was 4.3 years. The mean patient age was 45, 8 years (27-78 years). The mean cavernous malformation volume was 0.81 ml treated with a mean marginal radiation dose of 11.8 Gy (range: 5–19.2 Gy). Disease presentation was due to focal neurological deficits in 21 patients, seizures in six patients and headache in one patient. Four patients underwent radiosurgery for cavernous malformation after surgical resection. In five patients the disease was an incidental finding. The malformation was supratentorial in 20 cases and infratentorial in 14 cases. Three patients had multiple cavernous malformations.

Results

The mean follow-up period after radiosurgery was 4.3 years. After radiosurgery a total of four hemorrhages (10.8%) were observed. The new bleeding episodes occurred (as assessed clinically and by magnetic resonance imaging) between 0.6 and 1.8 years (mean one year) after treatment. One of those patients died because of rebleeding. In four cases acute rebleeding was seen in MRI images without neurological disturbance. Seizures were excellently controlled in all concerned patients. In our series radiation-induced complications developed in only one patient (paraparesis of the upper limb).

Conclusions

Our morbidity after radiosurgery is low (1/37 patients). Achievement of seizure control was possible in all patients. Radiosurgery appears to reduce the rate of hemorrhage after a 2-year latency but the results of longer follow-up reviews have to be critically compared to the natural history of cavernous malformations.