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Current Status of Radiosurgery for Arteriovenous Malformations

Published online by Cambridge University Press:  18 September 2015

Michael Schwartz ,
Peter O'Brien ,
Phillip Davey ,
Charlene Young ,
Robert Willinsky  and
Charles Catton
Michael Schwartz*
Affiliation:
University of Toronto, Brain Vascular Malformation Study Group, Toronto
Peter O'Brien
Affiliation:
University of Toronto, Brain Vascular Malformation Study Group, Toronto
Phillip Davey
Affiliation:
University of Toronto, Brain Vascular Malformation Study Group, Toronto
Charlene Young
Affiliation:
University of Toronto, Brain Vascular Malformation Study Group, Toronto
Robert Willinsky
Affiliation:
University of Toronto, Brain Vascular Malformation Study Group, Toronto
Charles Catton
Affiliation:
University of Toronto, Brain Vascular Malformation Study Group, Toronto
*
2075 Bayview Avenue, Suite A129, Toronto, Ontario, Canada M4N 3M5
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Abstract:

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Cerebral arteriovenous malformations (AVM), regardless of the mode of discovery, have an annual risk of hemorrhage of approximately 4 percent. A progressive obliterative vasculitis culminating in the occlusion of an AVM may be induced by the administration of radiation doses of approximately 20 Gy given in a single fraction. The process takes about two years and occlusion occurs in approximately 80% of patients so treated. Such a dose may be accurately administered to AVMs up to 3 cm in diameter with very little radiation imparted to the adjacent brain by means of multiple highly collimated radially arranged cobalt sources (the Gamma Knife) or by means of a modified linear accelerator turned through an arc or arcs with the target AVM as the centre of rotation. The Gamma Knife and the modified linear accelerator have nearly equal accuracy. Recent experience with modified linear accelerators indicates efficacy equal to the Gamma Knife. Both devices are effective treatment for small AVMs but the cost of modifying a pre-existing linear accelerator is only a few percent of the acquisition and installation costs of the Gamma Knife.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 18 , Issue 4 , November 1991 , pp. 499 - 502
Copyright
Copyright © Canadian Neurological Sciences Federation 1991

References

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