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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

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1];  [2];  [3];  [2];  [2];  [2];  [4];  [2];  [2]
  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)
  2. Department of Neurosurgery, University of Verona and University Hospital, Verona (Italy)
  3. Interdepartmental Centre of Economic Documentation, University of Verona and University Hospital, Verona (Italy)
  4. Department of Radiation Oncology, University of Verona and University Hospital, Verona (Italy)

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.

OSTI ID:
20793363
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 64, 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); ISSN 0360-3016
Country of Publication:
United States
Language:
English

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