Stereotactic radiosurgery in cerebral arteriovenous malformation

During a 1 1/2-year period, six patients with cerebral arteriovenous malformations (AVMs), have been referred to our institution to undergo stereotactic radiosurgery with a linear accelerator. All the patients underwent magnetic resonance (MR) imaging (1.5-T unit) and angiography in stereotactic conditions in order to plan the target plan for radiosurgery. The malformations were located in the cerebral hemispheres in 5 cases, and in the midbrain in one case. The radiosurgery was performed with a linear accelerator, a single dose of 4,000 - 4,500 rad was administered to one target point chosen in the nidus of the AVM. The patients underwent follow-up MR imaging each 3 months and angiography 6-12 months after the therapy. In all cases, both MR imaging and angiograhy showed a reduction in the size of the AVMs. In two cases, the malformation was completely obliterated on the angiographic and MR controls. The authors did not observe any bleeding during or after the treatment. These early results indicate that stereotactic radiosurgery has to be considered a competitive approach in the treatment of cerebral AVMs