Management and prognosis of cysts developed on long-term follow-up after Gamma Knife radiosurgery for intracranial arteriovenous malformations

Masahiro Izawa, Mikhail Chernov, Motohiro Hayashi, Kotaro Nakaya, Shuji Kamikawa, Koichi Kato, Takashi Higa, Hiroshi Ujiie, Hidetoshi Kasuya, Takakazu Kawamata, Yoshikazu Okada, Osami Kubo, Hiroshi Iseki, Tomokatsu Hori, Kintomo Takakura

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Delayed cyst formation is a well-recognized complication after radiosurgery for intracranial AVM. The objective of the present study was the evaluation of the different management options for these lesions and the corresponding prognosis of patients. Methods: Between 2000 and 2005, 12 patients with intracranial AVM initially treated by GKR were reevaluated at Tokyo Women's Medical University because of delayed cyst formation in the vicinity of the target area. There were 7 men and 5 women. The mean age of the patients was 31.8 years at the time of GKR and 41.1 years at the time of complication. The average period between treatment and diagnosis of the complication constituted 6.7 years. All AVMs had lobar location and showed complete angiographic obliteration after GKR. Results: The most common neurological signs and symptoms at the time of cyst presentation were headache (10 cases) and seizures (4 cases). Two patients were asymptomatic. Three patients underwent surgery soon after the diagnosis of the cyst, whereas initial observation was done in another 9. Among the latter, 5 patients had to be treated surgically thereafter because of persistent or aggravated neurological symptoms associated with radiological cyst expansion. Four other patients, including both asymptomatic ones, are in stable condition without surgery. Follow-up after treatment of the cyst varied from 7 to 60 months (average, 34.3 months). All patients are in good condition. Conclusions: Although delayed formation of cysts after GKR for intracranial AVM should be considered as a complication of the radiosurgical treatment, it has a relatively good prognosis. Observation can be recommended as initial option for compensated and asymptomatic patients.

Original languageEnglish
Pages (from-to)400-406
Number of pages7
JournalSurgical Neurology
Volume68
Issue number4
DOIs
Publication statusPublished - 2007 Oct
Externally publishedYes

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Intracranial Arteriovenous Malformations
Radiosurgery
Cysts
Observation
Tokyo
Signs and Symptoms
Headache
Seizures
Therapeutics

Keywords

  • Arteriovenous malformation
  • Complication
  • Cyst
  • Gamma Knife radiosurgery
  • Management
  • Prognosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Management and prognosis of cysts developed on long-term follow-up after Gamma Knife radiosurgery for intracranial arteriovenous malformations. / Izawa, Masahiro; Chernov, Mikhail; Hayashi, Motohiro; Nakaya, Kotaro; Kamikawa, Shuji; Kato, Koichi; Higa, Takashi; Ujiie, Hiroshi; Kasuya, Hidetoshi; Kawamata, Takakazu; Okada, Yoshikazu; Kubo, Osami; Iseki, Hiroshi; Hori, Tomokatsu; Takakura, Kintomo.

In: Surgical Neurology, Vol. 68, No. 4, 10.2007, p. 400-406.

Research output: Contribution to journalArticle

Izawa, M, Chernov, M, Hayashi, M, Nakaya, K, Kamikawa, S, Kato, K, Higa, T, Ujiie, H, Kasuya, H, Kawamata, T, Okada, Y, Kubo, O, Iseki, H, Hori, T & Takakura, K 2007, 'Management and prognosis of cysts developed on long-term follow-up after Gamma Knife radiosurgery for intracranial arteriovenous malformations', Surgical Neurology, vol. 68, no. 4, pp. 400-406. https://doi.org/10.1016/j.surneu.2006.11.051
Izawa, Masahiro ; Chernov, Mikhail ; Hayashi, Motohiro ; Nakaya, Kotaro ; Kamikawa, Shuji ; Kato, Koichi ; Higa, Takashi ; Ujiie, Hiroshi ; Kasuya, Hidetoshi ; Kawamata, Takakazu ; Okada, Yoshikazu ; Kubo, Osami ; Iseki, Hiroshi ; Hori, Tomokatsu ; Takakura, Kintomo. / Management and prognosis of cysts developed on long-term follow-up after Gamma Knife radiosurgery for intracranial arteriovenous malformations. In: Surgical Neurology. 2007 ; Vol. 68, No. 4. pp. 400-406.
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abstract = "Background: Delayed cyst formation is a well-recognized complication after radiosurgery for intracranial AVM. The objective of the present study was the evaluation of the different management options for these lesions and the corresponding prognosis of patients. Methods: Between 2000 and 2005, 12 patients with intracranial AVM initially treated by GKR were reevaluated at Tokyo Women's Medical University because of delayed cyst formation in the vicinity of the target area. There were 7 men and 5 women. The mean age of the patients was 31.8 years at the time of GKR and 41.1 years at the time of complication. The average period between treatment and diagnosis of the complication constituted 6.7 years. All AVMs had lobar location and showed complete angiographic obliteration after GKR. Results: The most common neurological signs and symptoms at the time of cyst presentation were headache (10 cases) and seizures (4 cases). Two patients were asymptomatic. Three patients underwent surgery soon after the diagnosis of the cyst, whereas initial observation was done in another 9. Among the latter, 5 patients had to be treated surgically thereafter because of persistent or aggravated neurological symptoms associated with radiological cyst expansion. Four other patients, including both asymptomatic ones, are in stable condition without surgery. Follow-up after treatment of the cyst varied from 7 to 60 months (average, 34.3 months). All patients are in good condition. Conclusions: Although delayed formation of cysts after GKR for intracranial AVM should be considered as a complication of the radiosurgical treatment, it has a relatively good prognosis. Observation can be recommended as initial option for compensated and asymptomatic patients.",
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T1 - Management and prognosis of cysts developed on long-term follow-up after Gamma Knife radiosurgery for intracranial arteriovenous malformations

AU - Izawa, Masahiro

AU - Chernov, Mikhail

AU - Hayashi, Motohiro

AU - Nakaya, Kotaro

AU - Kamikawa, Shuji

AU - Kato, Koichi

AU - Higa, Takashi

AU - Ujiie, Hiroshi

AU - Kasuya, Hidetoshi

AU - Kawamata, Takakazu

AU - Okada, Yoshikazu

AU - Kubo, Osami

AU - Iseki, Hiroshi

AU - Hori, Tomokatsu

AU - Takakura, Kintomo

PY - 2007/10

Y1 - 2007/10

N2 - Background: Delayed cyst formation is a well-recognized complication after radiosurgery for intracranial AVM. The objective of the present study was the evaluation of the different management options for these lesions and the corresponding prognosis of patients. Methods: Between 2000 and 2005, 12 patients with intracranial AVM initially treated by GKR were reevaluated at Tokyo Women's Medical University because of delayed cyst formation in the vicinity of the target area. There were 7 men and 5 women. The mean age of the patients was 31.8 years at the time of GKR and 41.1 years at the time of complication. The average period between treatment and diagnosis of the complication constituted 6.7 years. All AVMs had lobar location and showed complete angiographic obliteration after GKR. Results: The most common neurological signs and symptoms at the time of cyst presentation were headache (10 cases) and seizures (4 cases). Two patients were asymptomatic. Three patients underwent surgery soon after the diagnosis of the cyst, whereas initial observation was done in another 9. Among the latter, 5 patients had to be treated surgically thereafter because of persistent or aggravated neurological symptoms associated with radiological cyst expansion. Four other patients, including both asymptomatic ones, are in stable condition without surgery. Follow-up after treatment of the cyst varied from 7 to 60 months (average, 34.3 months). All patients are in good condition. Conclusions: Although delayed formation of cysts after GKR for intracranial AVM should be considered as a complication of the radiosurgical treatment, it has a relatively good prognosis. Observation can be recommended as initial option for compensated and asymptomatic patients.

AB - Background: Delayed cyst formation is a well-recognized complication after radiosurgery for intracranial AVM. The objective of the present study was the evaluation of the different management options for these lesions and the corresponding prognosis of patients. Methods: Between 2000 and 2005, 12 patients with intracranial AVM initially treated by GKR were reevaluated at Tokyo Women's Medical University because of delayed cyst formation in the vicinity of the target area. There were 7 men and 5 women. The mean age of the patients was 31.8 years at the time of GKR and 41.1 years at the time of complication. The average period between treatment and diagnosis of the complication constituted 6.7 years. All AVMs had lobar location and showed complete angiographic obliteration after GKR. Results: The most common neurological signs and symptoms at the time of cyst presentation were headache (10 cases) and seizures (4 cases). Two patients were asymptomatic. Three patients underwent surgery soon after the diagnosis of the cyst, whereas initial observation was done in another 9. Among the latter, 5 patients had to be treated surgically thereafter because of persistent or aggravated neurological symptoms associated with radiological cyst expansion. Four other patients, including both asymptomatic ones, are in stable condition without surgery. Follow-up after treatment of the cyst varied from 7 to 60 months (average, 34.3 months). All patients are in good condition. Conclusions: Although delayed formation of cysts after GKR for intracranial AVM should be considered as a complication of the radiosurgical treatment, it has a relatively good prognosis. Observation can be recommended as initial option for compensated and asymptomatic patients.

KW - Arteriovenous malformation

KW - Complication

KW - Cyst

KW - Gamma Knife radiosurgery

KW - Management

KW - Prognosis

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