Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms
Objective The incidence of aneurysms coexisting with arteriovenous malformations (AVMs) ranges between 2.7% and 16.7%. The anatomical relationship between AVM and aneurysm is critical in deciding the best management. Methods Between October 1994 and August 2017, gamma knife surgery (GKS)...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-12-01
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| Series: | Indian Journal of Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718239 |
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| author | Jungwook Baek Mooseong Kim Seyoung Pyo Youngjin Heo Seong Ho Kim Cheol Ahn Jeongeun Kim |
| author_facet | Jungwook Baek Mooseong Kim Seyoung Pyo Youngjin Heo Seong Ho Kim Cheol Ahn Jeongeun Kim |
| author_sort | Jungwook Baek |
| collection | DOAJ |
| description | Objective The incidence of aneurysms coexisting with arteriovenous malformations (AVMs) ranges between 2.7% and 16.7%. The anatomical relationship between AVM and aneurysm is critical in deciding the best management.
Methods Between October 1994 and August 2017, gamma knife surgery (GKS) was performed in six patients with AVMs and associated aneurysms. The patients consisted of four men and two women with a mean age of 37.8 years (range, 18−57 years). The mean follow-up was 34.2 months (range, 13−84 months). The mean maximal dose was 35.9 Gy and the mean margin dose to AVM was 18 Gy. Coil embolization was performed in one of the aneurysms prior to GKS. In our study, GKS was performed in six AVM-associated aneurysms. Of the six aneurysms, four were intranidal and two were pedicular. The mean volume of AVMs was 3.6 cm3 (range, 1.6−6.5 cm3).
Results The locations of aneurysms are as follows: four on posterior cerebral artery (PCA), one on posterior inferior cerebellar artery (PICA), and one on middle cerebral artery (MCA). Sublocation sites were MCA M3 above, PCA P3 above, and PICA distal. There were no GKS-related complications. Complete obliteration of AVM and aneurysm was documented in all four patients with intranidal aneurysm-associated AVMs. Both the aneurysm and AVM were completely obliterated in the two patients with proximal pedicular aneurysms.
Conclusion GKS is a possible treatment for AVM with associated intranidal or pedicular aneurysms located above P3 or M3, etc., in which there is less turbulent flow and jet flow. |
| format | Article |
| id | doaj-art-fa3fd087b91b4a089a14ffcb94264ada |
| institution | OA Journals |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-fa3fd087b91b4a089a14ffcb94264ada2025-08-20T02:22:41ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672022-12-01110326526810.1055/s-0040-1718239Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial AneurysmsJungwook Baek0Mooseong Kim1Seyoung Pyo2Youngjin Heo3Seong Ho Kim4Cheol Ahn5Jeongeun Kim6Department of Neurological Surgery, Inje University Busan Paik Hospital, Busan, South KoreaDepartment of Neurological Surgery, Inje University Busan Paik Hospital, Busan, South KoreaDepartment of Neurological Surgery, Inje University Busan Paik Hospital, Busan, South KoreaDepartment of Diagnostic Radiology, Inje University Busan Paik Hospital, Busan, South KoreaDepartment of Neurological Surgery, DaeKoo, KoreaDepartment of Neurological Surgery, ChoonHae Hospital, Busan, KoreaBoston University College of Arts and Sciences: Biology, Boston, Massachusetts, United StatesObjective The incidence of aneurysms coexisting with arteriovenous malformations (AVMs) ranges between 2.7% and 16.7%. The anatomical relationship between AVM and aneurysm is critical in deciding the best management. Methods Between October 1994 and August 2017, gamma knife surgery (GKS) was performed in six patients with AVMs and associated aneurysms. The patients consisted of four men and two women with a mean age of 37.8 years (range, 18−57 years). The mean follow-up was 34.2 months (range, 13−84 months). The mean maximal dose was 35.9 Gy and the mean margin dose to AVM was 18 Gy. Coil embolization was performed in one of the aneurysms prior to GKS. In our study, GKS was performed in six AVM-associated aneurysms. Of the six aneurysms, four were intranidal and two were pedicular. The mean volume of AVMs was 3.6 cm3 (range, 1.6−6.5 cm3). Results The locations of aneurysms are as follows: four on posterior cerebral artery (PCA), one on posterior inferior cerebellar artery (PICA), and one on middle cerebral artery (MCA). Sublocation sites were MCA M3 above, PCA P3 above, and PICA distal. There were no GKS-related complications. Complete obliteration of AVM and aneurysm was documented in all four patients with intranidal aneurysm-associated AVMs. Both the aneurysm and AVM were completely obliterated in the two patients with proximal pedicular aneurysms. Conclusion GKS is a possible treatment for AVM with associated intranidal or pedicular aneurysms located above P3 or M3, etc., in which there is less turbulent flow and jet flow.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718239aneurysmarteriovenous malformationgamma knife |
| spellingShingle | Jungwook Baek Mooseong Kim Seyoung Pyo Youngjin Heo Seong Ho Kim Cheol Ahn Jeongeun Kim Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms Indian Journal of Neurosurgery aneurysm arteriovenous malformation gamma knife |
| title | Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms |
| title_full | Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms |
| title_fullStr | Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms |
| title_full_unstemmed | Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms |
| title_short | Case Series for Gamma Knife Surgery for Arteriovenous Malformation Associated Intracranial Aneurysms |
| title_sort | case series for gamma knife surgery for arteriovenous malformation associated intracranial aneurysms |
| topic | aneurysm arteriovenous malformation gamma knife |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718239 |
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