Steinvorth Sarah, Wenz Frederik, Wildermuth Susanne, Essig Marco, Fuss Martin, Lohr Frank, Debus Jürgen, Wannenmacher Michael, Hacke Werner
Department of Neurology, University of Heidelberg, Heidelberg, Germany.
Int J Radiat Oncol Biol Phys. 2002 Dec 1;54(5):1430-7. doi: 10.1016/s0360-3016(02)03800-2.
To evaluate the long-term cognitive function of patients with cerebral arteriovenous malformations (AVMs) after radiosurgery.
The data of 95 AVM patients were prospectively assessed up to 3 years after radiosurgery. Of these patients, 39 had a follow-up of at least 2 years. Radiosurgery was performed using a modified linear accelerator (minimal doses to the target volume 15-22 Gy, median dose 20). The neuropsychological evaluation included testing of intelligence, attention, and memory. The effect of a preexisting intracranial hemorrhage, as well as AVM occlusion, on cognitive functions was analyzed after 1 and 2 years.
No cognitive declines were observed during follow-up. Instead significant improvements occurred in intelligence (1 year, +6.1 IQ points; 2 years, +5.1 IQ points), memory (1 year, +18.3 percentile score; 2 years, +12.2 percentile score), and attention (1 year, +19 percentile score; 2 years, +18 percentile score). Patients without previous intracranial hemorrhage improved more than patients with intracranial hemorrhage, although this difference was not statistically significant. The role of AVM occlusion on cognitive function is not clear at present.
Radiosurgery does not induce measurable deterioration of cognitive function in patients with cerebral AVMs.
评估脑动静脉畸形（AVM）患者接受放射外科治疗后的长期认知功能。
前瞻性评估95例AVM患者放射外科治疗后长达3年的数据。其中39例患者随访至少2年。使用改良直线加速器进行放射外科治疗（靶体积最小剂量15 - 22 Gy，中位剂量20）。神经心理学评估包括智力、注意力和记忆力测试。在1年和2年后分析既往颅内出血以及AVM闭塞对认知功能的影响。
随访期间未观察到认知功能下降。相反，智力（1年时智商提高6.1分；2年时提高5.1分）、记忆力（1年时百分位数得分提高18.3；2年时提高12.2）和注意力（1年时百分位数得分提高19；2年时提高18）均有显著改善。既往无颅内出血的患者比有颅内出血的患者改善更多，尽管这种差异无统计学意义。目前尚不清楚AVM闭塞对认知功能的作用。
放射外科治疗不会导致脑AVM患者出现可测量的认知功能恶化。
