AI Summary & Key Takeaways
AI InsightArandomized controlled trial is needed that compares GKRS to observation if we want to establish the true efficacy of this treatment.
📌 3 Key Takeaways
Özet
AIM: To assess treatment results of gamma knife radiosurgery (GKRS) for hemorrhagic brainstem cavernous malformations (BSCMs).MATERIAL and METHODS: A retrospective review of patients with hemorrhagic BSCMs, who were treated at the AcıbademKozyatagi Hospital GKRS unit from May 2007 to October 2015 was performed.RESULTS: In total, 82 patients were identified. All patients had experienced at least one hemorrhagic event (range 1-3), and all ofthem presented with radiological evidence of hemorrhage. The median target volume was 0.3 ml, and the median marginal radiationdose was 12 Gy. The mean durations before and after surgery were 25.5 (range 1-204) months, and 50.3 (range 13-113) months,respectively. Pre-treatment hemorrhage rates were calculated from the date of first hemorrhage to the date of radiosurgery. Therewere 97 bleeds over 174.4 patient-years during the observation period, with an annual hemorrhage rate of 55.7%. If the first bleedis excluded, the annual hemorrhage rate was 8.6%. Only three patients demonstrated re-bleeding, which occurred at 3, 12 and79 months after radiosurgery. Over a total follow up time of 344 patient-years the annual re-bleeding rate was therefore 0.87%,indicating that the risk of BSCM hemorrhage was significantly decreased by radiosurgery.CONCLUSION: GKRS was a safe and effective treatment for symptomatic low volume BSCMs when a low marginal dose is used. Arandomized controlled trial is needed that compares GKRS to observation if we want to establish the true efficacy of this treatment.