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Title: Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period

Abstract

Purpose: To compare the epidemiologic, morphologic, and clinical characteristics of 92 children/adolescents (Group A) and 362 adults (Group B) with cerebral arteriovenous malformations (cAVMs) considered suitable for radiosurgery; to correlate radiosurgery-related permanent complication and post-radiosurgery bleeding rates in the 75 children/adolescents and 297 adults available for follow-up. Methods and Materials: Radiosurgery was performed with a model C 201-source Co{sup 6} Leksell Gamma Unit (Elekta Instruments, Stockholm, Sweden). Fisher exact two-tailed, Wilcoxon rank-sum, and two-sample binomial exact tests were used for statistical analysis. Results: There were significant differences between the two populations in sex (p = 0.015), clinical presentation (p = 0.001), and location (p = 0.008). The permanent complication rate was lower in younger (1.3%) than in older patients (5.4%), although the difference was not significant (p = 0.213). The postradiosurgery bleeding rate was lower in Group A (1.3%) than in Group B (2.7%) (p = 0.694), with global actuarial bleeding rates of 0.56% per year and 1.15% per year, respectively. Conclusions: The different characteristics of child/adolescent and adult cAVMs suggest that they should be considered two distinct vascular disorders. The similar rates of radiosurgery-related complications and latency period bleeding in the two populations show that gamma knife radiosurgery doesmore » not expose young patients to a higher risk of sequelae than that for older patients.« less

Authors:
 [1];  [2];  [3];  [4];  [2];  [3];  [2];  [3];  [2];  [3];  [5];  [2];  [3];  [2];  [3]
  1. Department of Neurosurgery, University of Verona and University Hospital, Verona (Italy) and Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona (Italy). E-mail: antonio.nicolato@mail.azosp.vr.it
  2. Department of Neurosurgery, University of Verona and University Hospital, Verona (Italy)
  3. (Italy)
  4. Interdepartmental Centre of Economic Documentation, University of Verona and University Hospital, Verona (Italy)
  5. Department of Radiation Oncology, University of Verona and University Hospital, Verona (Italy)
Publication Date:
OSTI Identifier:
20793363
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 64; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2005.07.983; PII: S0360-3016(05)02376-X; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADOLESCENTS; ADULTS; CHILDREN; HAZARDS; LATENCY PERIOD; MALFORMATIONS; PATIENTS; RADIOTHERAPY; SEX; SURGERY

Citation Formats

Nicolato, Antonio, Lupidi, Francesco, Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Sandri, Marco F., Foroni, Roberto, Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Zampieri, Piergiuseppe, Section of Neuroradiology, University of Verona and University Hospital, Verona, Mazza, Carlo, Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona, Maluta, Sergio, Beltramello, Alberto, Section of Neuroradiology, University of Verona and University Hospital, Verona, Gerosa, Massimo, and Neurosurgical Clinic, University of Verona and University Hospital, Verona. Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Nicolato, Antonio, Lupidi, Francesco, Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Sandri, Marco F., Foroni, Roberto, Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Zampieri, Piergiuseppe, Section of Neuroradiology, University of Verona and University Hospital, Verona, Mazza, Carlo, Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona, Maluta, Sergio, Beltramello, Alberto, Section of Neuroradiology, University of Verona and University Hospital, Verona, Gerosa, Massimo, & Neurosurgical Clinic, University of Verona and University Hospital, Verona. Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period. United States. doi:10.1016/J.IJROBP.2005.0.
Nicolato, Antonio, Lupidi, Francesco, Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Sandri, Marco F., Foroni, Roberto, Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Zampieri, Piergiuseppe, Section of Neuroradiology, University of Verona and University Hospital, Verona, Mazza, Carlo, Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona, Maluta, Sergio, Beltramello, Alberto, Section of Neuroradiology, University of Verona and University Hospital, Verona, Gerosa, Massimo, and Neurosurgical Clinic, University of Verona and University Hospital, Verona. Wed . "Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20793363,
title = {Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period},
author = {Nicolato, Antonio and Lupidi, Francesco and Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona and Sandri, Marco F. and Foroni, Roberto and Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona and Zampieri, Piergiuseppe and Section of Neuroradiology, University of Verona and University Hospital, Verona and Mazza, Carlo and Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona and Maluta, Sergio and Beltramello, Alberto and Section of Neuroradiology, University of Verona and University Hospital, Verona and Gerosa, Massimo and Neurosurgical Clinic, University of Verona and University Hospital, Verona},
abstractNote = {Purpose: To compare the epidemiologic, morphologic, and clinical characteristics of 92 children/adolescents (Group A) and 362 adults (Group B) with cerebral arteriovenous malformations (cAVMs) considered suitable for radiosurgery; to correlate radiosurgery-related permanent complication and post-radiosurgery bleeding rates in the 75 children/adolescents and 297 adults available for follow-up. Methods and Materials: Radiosurgery was performed with a model C 201-source Co{sup 6} Leksell Gamma Unit (Elekta Instruments, Stockholm, Sweden). Fisher exact two-tailed, Wilcoxon rank-sum, and two-sample binomial exact tests were used for statistical analysis. Results: There were significant differences between the two populations in sex (p = 0.015), clinical presentation (p = 0.001), and location (p = 0.008). The permanent complication rate was lower in younger (1.3%) than in older patients (5.4%), although the difference was not significant (p = 0.213). The postradiosurgery bleeding rate was lower in Group A (1.3%) than in Group B (2.7%) (p = 0.694), with global actuarial bleeding rates of 0.56% per year and 1.15% per year, respectively. Conclusions: The different characteristics of child/adolescent and adult cAVMs suggest that they should be considered two distinct vascular disorders. The similar rates of radiosurgery-related complications and latency period bleeding in the two populations show that gamma knife radiosurgery does not expose young patients to a higher risk of sequelae than that for older patients.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 64,
place = {United States},
year = {2006},
month = {3}
}