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Journal of Korean Neurosurgical Society 2003;34(5): 407-411.
Gamma Knife Radiosurgery for Pediatric Arteriovenous Malformations.
Hyoung Seok Kim, Young Jin Lim, Jun Seok Koh, Bong Arm Rhee, Gook Ki Kim, Tae Sung Kim
Department of Neurosurgery, School of Medicine, Kyung-Hee University, Seoul, Korea. youngjinns@yahoo.co.kr
Stereotactic radiosurgery for arteriovenous malformation(AVM) is an accepted treatment option, however, few reports have been published on the results of this treatment in pediatrics. In this study, the authors describe a series of pediatric patients. METHODS: Between March 1992 and December 2000, 27 children with AVMs were treated with gamma knife radiosurgery. Follow-up information was available in 18 of these patients. The mean age at the time of initial treatment was 11.2 years(range, 7-16 years). Twelve children(66.7%) presented with hemorrhage and 6 children(33.3%) had non-hemorrhagic symptoms(seizure in 2 cases, headache in 4 cases). Eight AVMs were located in deep-seated area and 10 AVMs in cerebral hemisphere(7 cases in eloquent area, 3 cases in non-eloquent area). The mean marginal dose was 22.9Gy(range, 15-30Gy). The mean follow-up period was 52 months(range, 24-90 months). RESULTS: Complete obliteration was noted in 13 cases(72.3%), subtotal obliteration in 3 cases(16.5%) and partial obliteration in 2 cases(11.2%). One case(5.6%) suffered from rebleeding at 45 months after gamma knife radiosurgery and 2 cases(11.1%) experienced symptomatic adverse radiation effect at 1 and 10 months after gamma knife radiosugery. CONCLUSION: Gamma knife radiosurgery may be an effective treatment option for pediatric AVMs as adult AVMs. To establish the precise efficacy of radiosurgery for pediatric AVMs, wide experience and long-term follow up is mandatory.
Key Words: Pediatric arteriovenous malformation; Gamma knife radiosurgery
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