Introduction: The authors present the results of Gamma Knife stereotactic radiosurgery performed in a series of children with arteriovenous malformations (AVMs).
Methods: Between June 2005 and January 2014, 75 patients 18 years-old or younger received Gamma Knife radiosurgery for AVMs. Of these 58 patients were eligible for further analysis. The median age of the population was 12 years; 41% presented with hemorrhage and 34% with neurological insult and 24% patients were diagnosed incidentally. The median AVM volume was 3.5 cm3. The median radiosurgery based AVM score (RSBAVMS) was 0.86. The median follow-up period was 32 months.
Results: Single session gamma knife radiosurgery resulted in complete AVM obliteration in 40 (68.9%) patients. There were 35 (60.3%) excellent outcome (complete obliteration with no new deficits) in this series. During the follow up period, 9 (15.51%) patients experienced new deficits and 3 (5.1%) patients experienced intracranial hemorrhage. The annual rate of developing new deficits and hemorrhage was calculated as 5.45% and1.8%, respectively. Volume, gender, RSBAVMS and nidus type factor were factors associated with excellent outcome.
Conclusions: Radiosurgery was successful in majority of patients with minimal morbidity. Gamma Knife radiosurgery for AVMs can be a safe and successful method in pediatric patients.
Patient Care: Less invasive technique for selected cases
Learning Objectives: 1 Alternative Methods in Management of Pediatric AVMs