Gks For Cerebellar Arteriovenous Malformation

Keywords: gamma knife, radiosurgery, arteriovenous malformation, cerebellum, 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 assess the effect of GKS.
     26 patients were evaluated. 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 AVMs 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%).
     This was a retrospective study.
     GKS is very effective treatment for below 3 cm sized cerebellar AVM.
     AVMs with volume above 3 cm could be treated with target partial embolization followed by GKS.


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