Gamma knife radiosurgery for symptomatic brainstem cavernous malformations

Seong-Hyun Park1, Byung-Mok Kim2, Sung-Kyoo Hwang2

1Daegu, Korea, Republic Of 2Department of Neurosurgery, Kyungpook National University Hospital

Keywords: cavernous malformation, radiosurgery, gamma knife, outcome, vascular malformation

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     There are few series on cavernous malformation radiosurgery outcomes.
The purpose of this study was to evaluate the efficacy and safety of gamma knife radiosurgery (GKRS) for symptomatic brainstem cavernous malformations (CMs) associated with high surgical morbidity.
     Twenty patients with symptomatic brainstem CMs were treated by GKRS between 2005 and 2010. The mean age of patient was 41.1 years (range 24-69 years). All patients had experienced 1 or more symptomatic hemorrhages before GKRS (range 1-3). The median marginal radiation dose was 13 Gy, and the mean volume of malformation was 1.27 ml.
     The mean follow-up period after radiosurgery was 32.9 months (range 6-76 months).
     During the preradiosurgical period, 31 hemorrhages (1.55 per patient) were observed. The first hemorrhage of the 31 hemorrhages was excluded, leaving 11 subsequent hemorrhages observed. The annual hemorrhage rate before GKRS was 39.5%. In the postradiosurgical period, one hemorrhage (0.05 per patient) was identified. It occurred during the first 2 years after radiosurgery. The annual hemorrhage rate after GKRS was 10.0% for the first 2 years. After the expected latency period, no hemorrhage was identified. One patient had a new neurological symptom without hemorrhage after radiosurgery (5%) and recovered completely to a premorbid status.
     This was a retrospective study.
     GKRS seems to be relatively effective and safe for reducing the rebleeding rate for brainstem CMs with high surgical risk.


Project Roles:

S. Park (), B. Kim (), S. Hwang ()