Radiosurgery For Cavernous Malformations

Yoshihisa Kida1, Masayuki Yoshimoto1, Toshinori Hasegawa2

1Komaki City Hospital, Komaki/ Japan 2Komaki, Japan

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

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     Cavernous malformations (CM) are believed to be clinically silent, but sometimes become symptomatic causing repetitive hemorrhage or epilepsy. 
     We have already reported the radiosurgical results which indicate decreased hemorrhage rate and improved seizure control. However, because of lack of “natural history” of symptomatic lesions, those results are not so persuasive.
     There are 33 cases of symptomatic CM collected from near-by hospitals (Group A), which were against radiosurgery and choose either surgical removal or just watching the course with conservative treatments. The other 152 cases (Group B) were also symptomatic and treated with gamma knife in our institution. The mean ages of Group A and B were 44 and 38 years respectively.
      Our cases were treated by gamma knife with the mean maximum and marginal doses of 26.4 and 14.9 Gy respectively.
      Among them, 30% of lesions showed a shrinkage and the others were unchanged in the mean follow-up of 55.4 months. The hemorrhage rate is 7.6%/year/case in (A) with the mean follow-up period of 62 months. In contrast, that is 3.2%/year/case in (B) with the mean follow-up period of 55.4 months after radiosurgery, indicating a far better hemorrhage control.
     This is a retrospective study.
     When compared with the “natural history” of symptomatic lesions, radiosurgery reduced the hemorrhage rate less than half.
     Therefore radiosurgery with gamma knife can effectively work for the control for symptomatic CM lesions.


Project Roles:

Y. Kida (), M. Yoshimoto (), T. Hasegawa ()