大型脑动静脉畸形的伽玛刀体积分割治疗

目的 探讨伽玛刀体积分割治疗大型(体积＞10 cm3)脑动静脉畸形(AVM)的临床疗效.方法 回顾性分析2007～2017年收治的13例大小脑AVM的临床资料,均采用伽玛刀体积分割治疗,时间间隔3～18个月,治疗的AVM总体积平均为18.2 cm3(13.5～52 cm3),首次治疗的体积平均为14.1 cm3(8～2...

Volume-staged gamma knife radiosurgery for large cerebral arteriovenous malformations (report of 13 cases)

Objective To explore the clinical efficacy of volume-staged gamma knife radiosurgery for the patients with large (volume, >10 cm3) brain arteriovenous malformations (AVMs). Methods The clinical data of 13 patients with large brain AVM who underwent volume-staged gamma knife radiosurgery from 2007 to 2017 were analyzed retrospectively. The interval time between the first treatment and the second treatment ranged from 3 months to 18 months. The total volume of AVM ranged from 13.5 cm3 to 52 cm3, with an average of 18.2 cm3. The volume of the first treatment ranged from 8 to 23 cm3, with an average of 14.1 cm3. Marginal dose ranged from 14 Gy to 20 Gy, with an average of 16.6 Gy. The follow-up ranged from 24 months to 92 months, with an average of 43.2 months. Results The last follow-up images showed that the obliteration of AVM was achieved in 6 patients, and the lesion volume reduced by >75% in 4 and <50% in 3. Of 8 patients with preopertive epilepsy, 6 patients were relieved or improved. One patient suffered from cerebral hemorrhage 7 months after the treatment, and 1 patient suffered from limb sensorimotor dysfunction due to brain radiation side effects 6 months after the treatment. Conclusions Volume-staged gamma knife radiosurgery is a safe and effective method for the treatment of large brain AVMs, and most clinical symptoms can be significantly improved.