Management of adverse radiation effects after radiosurgery for arteriovenous malformations.

Management of adverse radiation effects after radiosurgery for arteriovenous malformations. Prog Neurol Surg. 2013;27:107-18 Authors: Monaco EA, Niranjan A, Kano H, Flickinger JC, Kondziolka D, Lunsford LD Abstract Over the last two decades, stereotactic radiosurgery (SRS) has become a mainstay in the management of arteriovenous malformations (AVMs) of the brain. An extensive collective experience has demonstrated that SRS is a minimally invasive technique that can produce excellent AVM obliteration rates with only a modest risk of permanent adverse radiation effects (AREs). Controversy remains regarding the optimal treatment approach for AVMs, with much of the debate centered upon the risk:benefit ratios of microsurgical resection versus SRS. Proponents of surgery suggest that for appropriate Spetzler-Martin grade AVMs microsurgery harbors minimal morbidity and immediate cure. In contrast, supporters of SRS argue that many AVMs cannot be treated by microsurgery with limited morbidity, and that despite the possibility of hemorrhage during the latency to obliteration, the risk profile of SRS is more favorable. Unfortunately, a randomized clinic trial comparing microsurgery and SRS is not likely, so clinicians and patients must use available data to make their own decisions. Much effort has been expended to identify factors associated with AREs, defining their impact and predicting which patients are likely to have complete AVM obliter...
Source: Progress in Neurological Surgery - Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research