Outcomes of stereotaxic radiosurgery for subtentorial cavernous malformations

Abstract

The study objective is to estimate treatment success of gamma knife radiosurgery (GKRS) in the patients with subtentorial cavernous malformation (CM) based on follow-up data and magnetic resonance imaging (MRI).Materials and methods. The long-term follow-up of GKRS in 87 patients with CM in brain stem and cerebellum was obtained. The clinical outcomes were observed using phone-based SF-36 health status survey in 55 patients. MRI data was collected before and after GKRS within 1, 2, 3 and more years. The natural history of CM without GKRS were observed in 20 patients.Results. The 1st year MRI observation after GKRS have demonstrated CM reduction in 66,6 % patients. At subsequent MRI-control the tendency of increase in number of CM, reacted on irradiation, and continuation of started processes of its sclerotization is revealed. The fast reduction of CM sizes was associated with lower risk of recurrent hemorrhages, that were observed in 3 patients with slow reduction. The CM reduction was also associated with good clinical outcomes, that was observed in 64,5 % patients.Conclusion. The presence of CM reduction (72,4 %) and good clinical outcome in suggests GKRS as a frontline treatment modality in patient with subtentorial CM. In the cases of slow rate of treatment response and unexpired risk of repeated hemorrhage no mortality and significant disability were mentioned.