Radiosurgery For Cavernous MalformationsKeywords: gamma knife, radiosurgery, cavernous malformation, outcome, hemorrhageInteractive Manuscript
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What is the background behind your study?
Cavernous malformations (CM) are believed to be clinically silent, but sometimes become symptomatic causing repetitive hemorrhage or epilepsy.
What is the purpose of your study?
We have already reported the radiosurgical results which indicate decreased hemorrhage rate and improved seizure control. However, because of lack of “natural history” of symptomatic lesions, those results are not so persuasive.
Describe your patient group.
There are 33 cases of symptomatic CM collected from near-by hospitals (Group A), which were against radiosurgery and choose either surgical removal or just watching the course with conservative treatments. The other 152 cases (Group B) were also symptomatic and treated with gamma knife in our institution. The mean ages of Group A and B were 44 and 38 years respectively.
Describe what you did.
Our cases were treated by gamma knife with the mean maximum and marginal doses of 26.4 and 14.9 Gy respectively.
Describe your main findings.
Among them, 30% of lesions showed a shrinkage and the others were unchanged in the mean follow-up of 55.4 months. The hemorrhage rate is 7.6%/year/case in (A) with the mean follow-up period of 62 months. In contrast, that is 3.2%/year/case in (B) with the mean follow-up period of 55.4 months after radiosurgery, indicating a far better hemorrhage control.
Describe the main limitation of this study.
This is a retrospective study.
Describe your main conclusion.
When compared with the “natural history” of symptomatic lesions, radiosurgery reduced the hemorrhage rate less than half.
Describe the importance of your findings and how they can be used by others.
Therefore radiosurgery with gamma knife can effectively work for the control for symptomatic CM lesions.
Cavernous malformations (CM) are believed to be clinically silent, but sometimes become symptomatic causing repetitive hemorrhage or epilepsy.
We have already reported the radiosurgical results which indicate decreased hemorrhage rate and improved seizure control. However, because of lack of “natural history” of symptomatic lesions, those results are not so persuasive.
There are 33 cases of symptomatic CM collected from near-by hospitals (Group A), which were against radiosurgery and choose either surgical removal or just watching the course with conservative treatments. The other 152 cases (Group B) were also symptomatic and treated with gamma knife in our institution. The mean ages of Group A and B were 44 and 38 years respectively.
Our cases were treated by gamma knife with the mean maximum and marginal doses of 26.4 and 14.9 Gy respectively.
Among them, 30% of lesions showed a shrinkage and the others were unchanged in the mean follow-up of 55.4 months. The hemorrhage rate is 7.6%/year/case in (A) with the mean follow-up period of 62 months. In contrast, that is 3.2%/year/case in (B) with the mean follow-up period of 55.4 months after radiosurgery, indicating a far better hemorrhage control.
This is a retrospective study.
When compared with the “natural history” of symptomatic lesions, radiosurgery reduced the hemorrhage rate less than half.
Therefore radiosurgery with gamma knife can effectively work for the control for symptomatic CM lesions.
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