Stereotactic heavy-ion irradiation of intracranial vascular disorders

The development of precision microneurosurgical techniques has made the surgical removal of certain components of deep arteriovenous malformations located in previously inaccessible areas of the brain more feasible, with acceptable rates of surgical morbidity and mortality. However, there are still many deep intracranial vascular disorders that are not surgically accessible either because they are located deep within the critical brain structures or because of their enormous size involving considerable regions of normal or ischemic brain tissue. In treating this particular group of deep intracranial arteriovenous malformations, we are applying sterotactically-directed focal beams of charged particles for direct heavy-ion Bragg peak radiosurgery, or combining intraluminal embolization, surgical occlusion of the arterial feeding vessels and/or partial excision of the lesion, with stereotactic radiosurgery. During the past 24 months, 22 patients with deep intracranial arteriovenous malformations have been treated with stereotactic charged-particle Bragg peak radiosurgery at the 184-inch Synchrocyclotron