Radiosurgery for unruptured cerebral arteriovenous malformations
Yang SY et al. – Although radiosurgery tends to cause seizures temporarily, the radiosurgery may improve seizure outcomes in patients with arteriovenous malformations (AVM)–related seizures, especially in patients with AVM obliteration.Methods
- Between 1997 and 2006, 161 consecutive patients underwent radiosurgery for unruptured AVM and were retrospectively assessed with a mean follow-up of 89.8 months by their medical records, updated clinical information, and, when necessary, direct patient contact.
- Seizure outcome was assessed using the Engel seizure frequency scoring system.
- Of the 86 patients with a history of seizure before radiosurgery, 76.7% (66/86) were seizure-free and 58.1% (50/86) were medication-free at the last follow-up visit.
- Of the patients who achieved AVM obliteration, 96.7% (58/60) were seizure-free while 30.8% (8/26) of those patients who did not achieve AVM obliteration were seizure-free (p = 0.001).
- The proportion of patients who were medication-free was 81.7% (49/60) of the patients with obliteration and 3.8% (1/26) of patients without obliteration (p < 0.001).
- Of the 75 patients with no history of seizure before radiosurgery, 10 had provoked seizures due to the direct and indirect radiosurgical influences after radiosurgery.