Late clinical and radiological complications of stereotactical radiosurgery of arteriovenous malformations of the brain

摘要: Post-radiation injury of patients with brain arteriovenous malformations (AVM) include blood–brain barrier breakdown (BBBB), edema, and necrosis. Prevalence, clinical relevance, response to treatment are poorly known. We present a series consecutive AVM treated stereotactic radiosurgery describing the appearance radiation complications. Consecutive annual radiological follow-up (median length 63 months). Edema BBBB were classified in four groups (minimal, perilesional, moderate, or severe), noted together Clinical symptoms interest intracranial hypertension, new neurological deficits, seizures, hemorrhages. One hundred two cases, median age 34 years, 52 % male. Median irradiated volume 3.8 cc, dose margin nidus 18.5 Gy. Nineteen underwent second radiosurgery. Only 42.2 % remained free from injury. was found 43.1 %, 20.6 %, necrosis 6.9 %. Major (moderate severe moderate BBBB, necrosis) 20 102 (19.6 %). diameter >3 cm independent predictors. Time worst imaging 60 months. Patients major had hazard ratio for focal deficits 7.042 (p = 0.04), hypertension 2.857 (p = 0.025), hemorrhage into occluded 9.009 (p = 0.079), seizures not significant. is frequent increases risk Its late implies that current protocols need be extended time.