REVIEW  BRAIN ARTERIOVENOUS MALFORMATIONS 

Journal of Neurosurgical Sciences 2018 August;62(4):490-504

DOI: 10.23736/S0390-5616.18.04406-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Radiosurgery and radiotherapy for arteriovenous malformations: outcome predictors and review of the literature

Eugenia VLASKOU BADRA ¹, Ekin ERMIŞ ¹, Pasquale MORDASINI ², Evelyn HERRMANN ¹ ✉

¹ Department of Radiation Oncology, Bern University Hospital, University of Bern, Bern, Switzerland; ² University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, University of Bern, Bern, Switzerland

Arteriovenous malformations (AVMs) are rare congenital vascular pathologies. The reported overall annual hemorrhage rate is 3.0%, for unruptured AVMs it is 2.2%, and for ruptured AVMs, 4.5%. The main goal of AVM treatment is to prevent intracerebral hemorrhage. This is achieved by complete nidus eradication. Interventional treatment options include microsurgery, embolization and radiosurgery, as well as multimodal approaches. Radiosurgery is a safe and effective alternative to surgery or embolization, especially for AVMs located in deep or eloquent brain regions, where invasive treatment cannot be performed. With the introduction of the Leksell Gamma Knife, AVMs became one of the most common indications for radiosurgical interventions (nearly 30% of the first 15-year experience). The current review discusses the role of radiosurgery in the treatment of AVMs, with a focus on outcome predictors and a discussion of the relevant literature.

KEY WORDS: Radiosurgery - Radiotherapy - Arteriovenous malformations - Radiation oncology - Neurosurgery