Seo Y, Fukuoka S, Takanashi M, Nakagawara J, Suematsu K, Nakamura J, Nagashima K
Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido University, Sapporo, Japan.
Stereotact Funct Neurosurg. 1995;64 Suppl 1:98-109. doi: 10.1159/000098769.
To evaluate the effect of radiosurgery on angiographically occult vascular malformations (AOVMs), 9 patients treated with Gamma Knife surgery were followed up for 21-37 months. Eight patients had bleeding episodes, 1 had uncontrollable epilepsy. Rebleeding occurred in 3 AOVMs 5 or 6 months after treatment. One patient experienced transient radiation-induced edema. One patient underwent surgical extirpation due to uncontrollable epilepsy 21 months after Gamma Knife surgery. Histological findings revealed an arteriovenous malformation (AVM) and a cavernous angioma. There was hypertrophy of the internal membrane of the AVM, but no effect on the cavernous malformation. Radiosurgery should only be considered in cases of inoperable AOVM, because there is no definite proof that radiosurgery prevents AOVMs from rebleeding.
为评估放射外科治疗血管造影隐匿性血管畸形（AOVM）的效果，对9例行伽玛刀手术治疗的患者进行了21至37个月的随访。8例患者有出血发作，1例有无法控制的癫痫。3例AOVM在治疗后5或6个月发生再出血。1例患者出现短暂性放射性水肿。1例患者在伽玛刀手术后21个月因无法控制的癫痫接受了手术切除。组织学检查发现1例动静脉畸形（AVM）和1例海绵状血管瘤。AVM内膜有增生，但对海绵状畸形无影响。放射外科仅应在无法手术的AOVM病例中考虑，因为尚无明确证据表明放射外科可预防AOVM再出血。
