Gamma Knife Radiosurgery for Central Arteriovenous Malformations— A Single-Center Experience

Abstract

Introduction: Arteriovenous malformations with basal ganglia, brainstem, and thalamic locations represent difficult vessel anomalies with critical locations. These central aneurysms are related with high morbidity and mortality rates. This retrospective study aims to examine the results of patients with basal ganglia, brainstem, and thalamic arteriovenous malformations remedied with gamma knife radiosurgery (GKS) at our clinic. Method: May 2005 - December 2020, the results of patients with GKS basal ganglia, thalamus, and brainstem located AVM were analyzed, in Gazi University Gamma Knife Unit. Results: May 2005 - December 2020, a total of 859 patients with intracranial AVM were treated at the Gamma Knife Unit of the Gazi University Neurosurgery Clinic. Seventy-three patients with basal ganglia, brainstem, and thalamic locations were seen. Of the total 73 patients included in our study, 14 patients (19.2%) in the basal ganglia, 13 patients (17.8) in the brain stem, and 46 patients (63%) in the thalamic region were located. The mean volume of AVMs is 4565,54 mm3. The patients who underwent embolization before gamma knife surgery treatment were found to be 19.2%. The mean of AVMs' obliteration time after SRS is 38.4 months. We detected that there wasn't a remarkable statistical rate relationship between AVMs volume, Spetzler Martin grading scale, nidus type, gender, and prior embolization (p = 0.05). Conclusions: GKS is an best choice treatment method used for all AVMs today. However, it has been accepted as the first choice treatment method, especially in central AVMs, which are risky in terms of mortality and morbidity, and the results are also quite good.