GKSurgery for Cerebellar AVM

Keywords: arteriovenous malformation, gamma knife, cerebellum, radiosurgery, outcome

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     Cerebellar AVM is relative contraindication to surgery . 380 AVMs treated with GammaKnife radiosurgery(GKS) between 1994 and December 2008. 
     38 cerebellar AVMs were treated with GKS and 26 among them was evaluated to asscess the effect of GKS.
     Male to female ratio was 15:11, mean age was 38.9 years(15-67), mean volume was 13.3 cc(0.55-32.6 cc).
      The mean maximal dose was 33.3 Gy, the mean margin dose was 15.6 Gy. Follow up ranged from 2-63 months(mean 23 months). Feeding artery was PCA:21, SCA:1, PICA:2, AICA:2. PreGKS modalities consist of 2 embolization, 1 GKS. Double AVM were 2 cases(PCA & MCA feeder:both).
     There was complete obliteration in 11 patients(42.3%), subtotal(70 % decreased) obliteration in 5 patients (19.2%), partial obliteration in 9 patients(34.6%), no change in 1 patient (3.9%). Bleeding occurred in 1 patient after GKS. There was no radiation-induced complications.
     This was a retrospective review.
     GKS is very effective treatment for below 3 cm sized cerebellar AVM. 
     AVMs with volume above 3 cm could be treated with target partial embolizaion followed by GKS.


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