Aims and objectives
To highlight the usefulness of Cyber Knife Robotic radiosurgery in the management of Arteriovenousmalformation (AVM ).
To study sites of intracranial AVMs.
To evaluate response by pre and post cyber imaging appearance and clinical results.
To Illustrate the complications of the procedure.
Methods and materials
This study carried out at department of Cyberknife Robotic Radiosurgery,
Jinnah post graduate Medical centre,
Karachi, Pakistan.
Data is reviewed for a period of 4 yearsand 6 monthsfrom December 2012 till june 2017.
Patients with AVMs difficult to remove surgically or previous embolization has been tried were included in the study.
Untreated AVMs have a tendency to bleed with consequent morbidity and mortality so the principal aim of treatment therefore be improvement in survival,
quality of life,
and neurological progression free survival.
Results
A total of 210 patients were selected and treated with Cyberknife Robotic radiosurgery in 1-5 fractions as per indications.
AVMs of different intracranial sites but mainly supratentorial location were found which showed clinical and radiological successful outcome.
Only 9 patients with large AVMs experienced symptomatic radiation injury after irradiation of 7-24 months which clinically and radiologically resolved after medication on subsequent followup MRI.
No patient had permanent deficit attributable to radiosurgery.
Some patients also developed radiation induced brain edema but it was reversible with oral...
Conclusion
Large AVMs with a deep vascualr supply have remained a formidable surgical challange .
With the help of Cyber knife stereotactic radiosurgery,
patients with previously untreatable AVMs may now have a treatment option other than observation.Significant volume reduction of AVM on T1 contrast enhanced MRI brain shows overall good efficacy of radiosurgery.
Staged-volume Cyber Knife radiosurgery for larger AVMs is a practical treatment approach,
providing long-term occlusion rates and low risk of radiation .
Personal information
Dr Shazia Kadri
Consultant Radiologist
Cyberknife Robotic Radiosurgery / Radiology Departmenrt
Jinnah Postgraduate Medical Centre
Karachi,
pakistan
E mail :
[email protected]
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