X-ray stereotactic radiosurgery for cerebral arteriovenous malformation in the teenagers

Objective: To analyze the long-term results of cerebral arteriovenous malformation (AVM) in the teenagers treated by X-ray stereotactic radiosurgery (SRS). Methods: From May 1996 to May 1998, 66 patients with AVM were treated by X-ray SRS with 65 patients followed up for 3-5 years. There were 42 men and 24 women who ranged in age from 8 to 39 years. The AVM volume ranged from 0.32 cm3 to 42.88 cm3. The peripheral dose was prescribed to the 80% isodose line, which ranged from 18 Gy to 23 Gy, with a median of 19.3 Gy. Results: The complete obliteration rate was 65.2%, with 30.3% at 1 year and 62.1% at 2 years. Logistic regression analysis showed that the lesion volume was the only factor for obliteration, the complete obliteration rates were 87.1% and 45.7% for <10 cm3 and >10 cm3 (x2 = 10.644, P < 0.01). The median recovery period were 1.444 years and 1.813 years for <10 cm3 and > 10 cm3 (t = 2.066, P < 0.05), they were 1.448 years and 1.857 years for peripheral dose >20 Gy and < 20 Gy (t = 2.247, P < 0.05), showing relevancy to volume and peripheral dose. The complete obliteration rate and median recovery period were 65.5%, 64.9% (x2 = 0.003, P > 0.05) and 1.474 years, 1.667 years (t = 1.073, P > 0.05) for children and young people, showing irrelevancy to age. Conclusions: The X-ray SRS is effective and safe for cerebral AVM, it gives high obliteration rate for AVM of volume <10 cm3 and serves as an auxiliary to surgery and endovascular embolization