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Review

Gamma Knife Radiosurgery For Brain Vascular Malformations: Current Evidence And Future Tasks

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Pages 1351-1367 | Published online: 18 Nov 2019

References

  • Leksell DG. Stereotactic radiosurgery. Present status and future trends. Neurol Res. 1987;9(2):60–68. doi:10.1080/01616412.1987.117397752886946
  • Leksell L. Stereotactic radiosurgery. J Neurol Neurosurg Psychiatry. 1983;46(9):797–803. doi:10.1136/jnnp.46.9.7976352865
  • Massager N, Maris C, Nissim O, Devriendt D, Salmon I, Levivier M. Experimental analysis of radiation dose distribution in radiosurgery. II. Dose fall-off outside the target volume. Stereotact Funct Neurosurg. 2009;87(3):137–142. doi:10.1159/00020929319321965
  • Semwal MK, Singh S, Sarin A, Bhatnagar S, Pathak HC. Comparative clinical dosimetry with X-knife and gamma knife. Phys Med. 2012;28(3):269–272. doi:10.1016/j.ejmp.2011.07.00321803627
  • Steiner L, Forster D, Leksell L, Meyerson BA, Boethius J. Gammathalamotomy in intractable pain. Acta Neurochir (Wien). 1980;52(3–4):173–184. doi:10.1007/BF014020726158844
  • Leksell L. Cerebral radiosurgery. I. Gammathalamotomy in two cases of intractable pain. Acta Chir Scand. 1968;134(8):585–595.5713443
  • Niranjan A, Lunsford LD. Radiosurgery: where we were, are, and may be in the third millennium. Neurosurgery. 2000;46(3):531–543. doi:10.1097/00006123-200003000-0000210719848
  • Fleetwood IG, Steinberg GK. Arteriovenous malformations. Lancet. 2002;359(9309):863–873. doi:10.1016/S0140-6736(02)07946-111897302
  • Stapf C, Mohr JP, Pile-Spellman J, Solomon RA, Sacco RL, Connolly ES. Epidemiology and natural history of arteriovenous malformations. Neurosurg Focus. 2001;11(5):e1. doi:10.3171/foc.2001.11.5.2
  • Ogilvy CS, Stieg PE, Awad I, et al. AHA Scientific Statement: recommendations for the management of intracranial arteriovenous malformations: a statement for healthcare professionals from a special writing group of the Stroke Council, American Stroke Association. Stroke. 2001;32(6):1458–1471. doi:10.1161/01.STR.32.6.145811387517
  • Fukuda K, Majumdar M, Masoud H, et al. Multicenter assessment of morbidity associated with cerebral arteriovenous malformation hemorrhages. J Neurointerv Surg. 2017;9(7):664–668. doi:10.1136/neurintsurg-2016-01248527334979
  • Solomon RA, Connolly ES Jr. Arteriovenous malformations of the brain. N Engl J Med. 2017;376(19):1859–1866. doi:10.1056/NEJMra160740728489992
  • Choi JH, Mohr JP. Brain arteriovenous malformations in adults. Lancet Neurol. 2005;4(5):299–308. doi:10.1016/S1474-4422(05)70073-915847843
  • Friedlander RM. Clinical practice. Arteriovenous malformations of the brain. N Engl J Med. 2007;356(26):2704–2712. doi:10.1056/NEJMcp06719217596605
  • Starke RM, Kano H, Ding D, et al. Stereotactic radiosurgery for cerebral arteriovenous malformations: evaluation of long-term outcomes in a multicenter cohort. J Neurosurg. 2017;126(1):36–44. doi:10.3171/2015.9.JNS15131126943847
  • Pollock BE, Flickinger JC, Lunsford LD, Maitz A, Kondziolka D. Factors associated with successful arteriovenous malformation radiosurgery. Neurosurgery. 1998;42(6):1239–1244. discussion 1244–1237. doi:10.1097/00006123-199806000-000209632181
  • Pollock BE, Flickinger JC. A proposed radiosurgery-based grading system for arteriovenous malformations. J Neurosurg. 2002;96(1):79–85. doi:10.3171/jns.2002.96.1.007911794608
  • Flickinger JC, Kondziolka D, Maitz AH, Lunsford LD. An analysis of the dose-response for arteriovenous malformation radiosurgery and other factors affecting obliteration. Radiother Oncol. 2002;63(3):347–354. doi:10.1016/S0167-8140(02)00103-212142099
  • Liscák R, Vladyka V, Simonová G, et al. Arteriovenous malformations after Leksell gamma knife radiosurgery: rate of obliteration and complications. Neurosurgery. 2007;60(6):1005–1014. discussion 1015–1006. doi:10.1227/01.NEU.0000255474.60505.4A17538373
  • Kano H, Lunsford LD, Flickinger JC, et al. Stereotactic radiosurgery for arteriovenous malformations, Part 1: management of Spetzler-Martin Grade I and II arteriovenous malformations. J Neurosurg. 2012;116(1):11–20. doi:10.3171/2011.9.JNS10174022077452
  • Fokas E, Henzel M, Wittig A, Grund S, Engenhart-Cabillic R. Stereotactic radiosurgery of cerebral arteriovenous malformations: long-term follow-up in 164 patients of a single institution. J Neurol. 2013;260(8):2156–2162.23712798
  • Kano H, Flickinger JC, Yang HC, et al. Stereotactic radiosurgery for Spetzler-Martin Grade III arteriovenous malformations. J Neurosurg. 2014;120(4):973–981. doi:10.3171/2013.12.JNS13160024484227
  • Pollock BE, Kondziolka D, Flickinger JC, Patel AK, Bissonette DJ, Lunsford LD. Magnetic resonance imaging: an accurate method to evaluate arteriovenous malformations after stereotactic radiosurgery. J Neurosurg. 1996;85(6):1044–1049. doi:10.3171/jns.1996.85.6.10448929493
  • Lee CC, Reardon MA, Ball BZ, et al. The predictive value of magnetic resonance imaging in evaluating intracranial arteriovenous malformation obliteration after stereotactic radiosurgery. J Neurosurg. 2015;123(1):136–144. doi:10.3171/2014.10.JNS14156525839923
  • Starke RM, Yen CP, Ding D, Sheehan JP. A practical grading scale for predicting outcome after radiosurgery for arteriovenous malformations: analysis of 1012 treated patients. J Neurosurg. 2013;119(4):981–987. doi:10.3171/2013.5.JNS131123829820
  • Starke RM, Ding D, Kano H, et al. International multicenter cohort study of pediatric brain arteriovenous malformations. Part 2: outcomes after stereotactic radiosurgery. J Neurosurg Pediatr. 2017;19(2):136–148. doi:10.3171/2016.9.PEDS1628427911249
  • Hasegawa H, Hanakita S, Shin M, et al. Does advanced age affect the outcomes of stereotactic radiosurgery for cerebral arteriovenous malformation? World Neurosurg. 2018;109:e715–e723. doi:10.1016/j.wneu.2017.10.07129066317
  • Ding D, Xu Z, Yen CP, Starke RM, Sheehan JP. Radiosurgery for cerebral arteriovenous malformations in elderly patients: effect of advanced age on outcomes after intervention. World Neurosurg. 2015;84(3):795–804. doi:10.1016/j.wneu.2015.05.01225997797
  • Ding D, Yen CP, Starke RM, Xu Z, Sheehan JP. Effect of prior hemorrhage on intracranial arteriovenous malformation radiosurgery outcomes. Cerebrovasc Dis. 2015;39(1):53–62. doi:10.1159/00036995925547253
  • Lunsford LD, Kondziolka D, Flickinger JC, et al. Stereotactic radiosurgery for arteriovenous malformations of the brain. J Neurosurg. 1991;75(4):512–524.1885968
  • Pollock BE, Flickinger JC, Lunsford LD, Bissonette DJ, Kondziolka D. Factors that predict the bleeding risk of cerebral arteriovenous malformations. Stroke. 1996;27(1):1–6. doi:10.1161/01.STR.27.1.18553382
  • Karlsson B, Lindquist C, Steiner L. Prediction of obliteration after gamma knife surgery for cerebral arteriovenous malformations. Neurosurgery. 1997;40(3):425–430. discussion 430–421. doi:10.1097/00006123-199703000-000019055280
  • Schwartz M, Sixel K, Young C, et al. Prediction of obliteration of arteriovenous malformations after radiosurgery: the obliteration prediction index. Can J Neurol Sci. 1997;24(2):106–109. doi:10.1017/S03171671000214179164685
  • Flickinger JC, Kondziolka D, Maitz AH, Lunsford LD. Analysis of neurological sequelae from radiosurgery of arteriovenous malformations: how location affects outcome. Int J Radiat Oncol Biol Phys. 1998;40(2):273–278. doi:10.1016/S0360-3016(97)00718-99457809
  • Ellis TL, Friedman WA, Bova FJ, Kubilis PS, Buatti JM. Analysis of treatment failure after radiosurgery for arteriovenous malformations. J Neurosurg. 1998;89(1):104–110. doi:10.3171/jns.1998.89.1.01049647180
  • Gallina P, Merienne L, Meder JF, Schlienger M, Lefkopoulos D, Merland JJ. Failure in radiosurgery treatment of cerebral arteriovenous malformations. Neurosurgery. 1998;42(5):996–1002. discussion 1002–1004. doi:10.1097/00006123-199805000-000249588543
  • Kwon Y, Jeon SR, Kim JH, et al. Analysis of the causes of treatment failure in gamma knife radiosurgery for intracranial arteriovenous malformations. J Neurosurg. 2000;93(Suppl 3):104–106. doi:10.3171/jns.2000.93.supplement_3.010411143225
  • Shin M, Kawamoto S, Kurita H, et al. Retrospective analysis of a 10-year experience of stereotactic radio surgery for arteriovenous malformations in children and adolescents. J Neurosurg. 2002;97(4):779–784. doi:10.3171/jns.2002.97.4.077912405363
  • Pollock BE, Gorman DA, Coffey RJ. Patient outcomes after arteriovenous malformation radiosurgical management: results based on a 5- to 14-year follow-up study. Neurosurgery. 2003;52(6):1291–1296. discussion 1296–1297. doi:10.1227/01.NEU.0000064800.26214.FE12762874
  • Pan DH, Kuo YH, Guo WY, et al. Gamma Knife surgery for cerebral arteriovenous malformations in children: a 13-year experience. J Neurosurg Pediatr. 2008;1(4):296–304. doi:10.3171/PED/2008/1/4/29618377305
  • Wegner RE, Oysul K, Pollock BE, et al. A modified radiosurgery-based arteriovenous malformation grading scale and its correlation with outcomes. Int J Radiat Oncol Biol Phys. 2011;79(4):1147–1150. doi:10.1016/j.ijrobp.2009.12.05620605347
  • Nicolato A, Longhi M, Tommasi N, et al. Leksell Gamma Knife for pediatric and adolescent cerebral arteriovenous malformations: results of 100 cases followed up for at least 36 months. J Neurosurg Pediatr. 2015;16(6):736–747. doi:10.3171/2015.4.PEDS15826339954
  • Hanakita S, Koga T, Shin M, Igaki H, Saito N. The long-term outcomes of radiosurgery for arteriovenous malformations in pediatric and adolescent populations. J Neurosurg Pediatr. 2015;16(2):222–231. doi:10.3171/2015.1.PEDS1440725955806
  • Pandey P, Marks MP, Harraher CD, et al. Multimodality management of Spetzler-Martin Grade III arteriovenous malformations. J Neurosurg. 2012;116(6):1279–1288. doi:10.3171/2012.3.JNS11157522482792
  • Shin M, Maruyama K, Kurita H, et al. Analysis of nidus obliteration rates after gamma knife surgery for arteriovenous malformations based on long-term follow-up data: the University of Tokyo experience. J Neurosurg. 2004;101(1):18–24. doi:10.3171/jns.2004.101.1.001815255246
  • Ganz JC, Reda WA, Abdelkarim K. Adverse radiation effects after Gamma Knife Surgery in relation to dose and volume. Acta Neurochir (Wien). 2009;151(1):9–19. doi:10.1007/s00701-008-0174-419129961
  • Flickinger JC, Lunsford LD, Kondziolka D, et al. Radiosurgery and brain tolerance: an analysis of neurodiagnostic imaging changes after gamma knife radiosurgery for arteriovenous malformations. Int J Radiat Oncol Biol Phys. 1992;23(1):19–26. doi:10.1016/0360-3016(92)90539-T1572817
  • Flickinger JC, Kondziolka D, Lunsford LD, et al. A multi-institutional analysis of complication outcomes after arteriovenous malformation radiosurgery. Int J Radiat Oncol Biol Phys. 1999;44(1):67–74. doi:10.1016/S0360-3016(98)00518-510219796
  • Flickinger JC, Kondziolka D, Lunsford LD, et al. Development of a model to predict permanent symptomatic postradiosurgery injury for arteriovenous malformation patients. Arteriovenous Malformation Radiosurgery Study Group. Int J Radiat Oncol Biol Phys. 2000;46(5):1143–1148. doi:10.1016/S0360-3016(99)00513-110725624
  • Cohen-Inbar O, Lee CC, Xu Z, Schlesinger D, Sheehan JP. A quantitative analysis of adverse radiation effects following Gamma Knife radiosurgery for arteriovenous malformations. J Neurosurg. 2015;123(4):945–953. doi:10.3171/2014.10.JNS14226425909572
  • Yen CP, Matsumoto JA, Wintermark M, et al. Radiation-induced imaging changes following Gamma Knife surgery for cerebral arteriovenous malformations. J Neurosurg. 2013;118(1):63–73. doi:10.3171/2012.10.JNS1240223140155
  • Maruyama K, Kawahara N, Shin M, et al. The risk of hemorrhage after radiosurgery for cerebral arteriovenous malformations. N Engl J Med. 2005;352(2):146–153. doi:10.1056/NEJMoa04090715647577
  • Pollock BE, Flickinger JC, Lunsford LD, Bissonette DJ, Kondziolka D. Hemorrhage risk after stereotactic radiosurgery of cerebral arteriovenous malformations. Neurosurgery. 1996;38(4):652–659. discussion 659–661. doi:10.1227/00006123-199604000-000048692381
  • Karlsson B, Lax I, Söderman M. Risk for hemorrhage during the 2-year latency period following gamma knife radiosurgery for arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2001;49(4):1045–1051. doi:10.1016/S0360-3016(00)01432-211240246
  • Friedman WA, Blatt DL, Bova FJ, Buatti JM, Mendenhall WM, Kubilis PS. The risk of hemorrhage after radiosurgery for arteriovenous malformations. J Neurosurg. 1996;84(6):912–919. doi:10.3171/jns.1996.84.6.09128847584
  • Shin M, Kawahara N, Maruyama K, Tago M, Ueki K, Kirino T. Risk of hemorrhage from an arteriovenous malformation confirmed to have been obliterated on angiography after stereotactic radiosurgery. J Neurosurg. 2005;102(5):842–846. doi:10.3171/jns.2005.102.5.084215926707
  • Lindqvist M, Karlsson B, Guo WY, Kihlström L, Lippitz B, Yamamoto M. Angiographic long-term follow-up data for arteriovenous malformations previously proven to be obliterated after gamma knife radiosurgery. Neurosurgery. 2000;46(4):803–808. discussion 809–810. doi:10.1097/00006123-200004000-0000610764252
  • Szeifert GT, Salmon I, Baleriaux D, Brotchi J, Levivier M. Immunohistochemical analysis of a cerebral arteriovenous malformation obliterated by radiosurgery and presenting with re-bleeding. Case report. Neurol Res. 2003;25(7):718–721. doi:10.1179/01616410310120222814579789
  • Kurita H, Sasaki T, Kawamoto S, et al. Chronic encapsulated expanding hematoma in association with gamma knife stereotactic radiosurgery for a cerebral arteriovenous malformation. Case report. J Neurosurg. 1996;84(5):874–878. doi:10.3171/jns.1996.84.5.08748622164
  • Shuto T, Matsunaga S, Suenaga J. Surgical treatment for late complications following gamma knife surgery for arteriovenous malformations. Stereotact Funct Neurosurg. 2011;89(2):96–102. doi:10.1159/00032354321293169
  • Shuto T, Yagishita S, Matsunaga S. Pathological characteristics of cyst formation following gamma knife surgery for arteriovenous malformation. Acta Neurochir (Wien). 2015;157(2):293–298. doi:10.1007/s00701-014-2298-z25503297
  • Parkhutik V, Lago A, Aparici F, et al. Late clinical and radiological complications of stereotactical radiosurgery of arteriovenous malformations of the brain. Neuroradiology. 2013;55(4):405–412. doi:10.1007/s00234-012-1115-823183855
  • Izawa M, Hayashi M, Chernov M, et al. Long-term complications after gamma knife surgery for arteriovenous malformations. J Neurosurg. 2005;102(s_supplement):34–37. doi:10.3171/sup.2005.102.s_supplement.003415662777
  • Hasegawa H, Hanakita S, Shin M, et al. A comprehensive study of symptomatic late radiation-induced complications after radiosurgery for brain arteriovenous malformation: incidence, risk factors, and clinical outcomes. World Neurosurg. 2018;116:e556–e565. doi:10.1016/j.wneu.2018.05.03829772363
  • Ilyas A, Chen CJ, Ding D, et al. Cyst formation after stereotactic radiosurgery for brain arteriovenous malformations: a systematic review. J Neurosurg. 2017;1–10.
  • Pomeraniec IJ, Ding D, Starke RM, et al. Delayed cyst formation after stereotactic radiosurgery for brain arteriovenous malformations. J Neurosurg. 2017;1–10.
  • Matsuo T, Kamada K, Izumo T, Hayashi N, Nagata I. Cyst formation after linac-based radiosurgery for arteriovenous malformation: examination of predictive factors using magnetic resonance imaging. Clin Neurol Neurosurg. 2014;121:10–16. doi:10.1016/j.clineuro.2014.03.00624793466
  • Pollock BE, Link MJ, Branda ME, Storlie CB. Incidence and management of late adverse radiation effects after arteriovenous malformation radiosurgery. Neurosurgery. 2017. doi:10.1093/neuros/nyx010
  • Kano H, Flickinger JC, Tonetti D, et al. Estimating the risks of adverse radiation effects after gamma knife radiosurgery for arteriovenous malformations. Stroke. 2017;48(1):84–90. doi:10.1161/STROKEAHA.116.01482527899758
  • Yamamoto M, Jimbo M, Hara M, Saito I, Mori K. Gamma knife radiosurgery for arteriovenous malformations: long-term follow-up results focusing on complications occurring more than 5 years after irradiation. Neurosurgery. 1996;38(5):906–914. doi:10.1097/00006123-199605000-000108727815
  • Yamamoto M, Hara M, Ide M, Ono Y, Jimbo M, Saito I. Radiation-related adverse effects observed on neuro-imaging several years after radiosurgery for cerebral arteriovenous malformations. Surg Neurol. 1998;49(4):385–397. discussion 397–388. doi:10.1016/S0090-3019(97)00531-49537656
  • Hasegawa T, Kato T, Naito T, et al. Long-term outcomes for pediatric patients with brain arteriovenous malformations treated with gamma knife radiosurgery, Part 2: the incidence of cyst formation, encapsulated hematoma, and radiation-induced tumor. World Neurosurg. 2019;126:e1526–e1536. doi:10.1016/j.wneu.2019.03.17730922905
  • Nakajima H, Yamanaka K, Ishibashi K, Iwai Y. Delayed cyst formations and/or expanding hematomas developing after Gamma Knife surgery for cerebral arteriovenous malformations. J Clin Neurosci. 2016;33:96–99. doi:10.1016/j.jocn.2016.01.04427430414
  • Pan HC, Sheehan J, Stroila M, Steiner M, Steiner L. Late cyst formation following gamma knife surgery of arteriovenous malformations. J Neurosurg. 2005;102(s_supplement):124–127. doi:10.3171/jns.2005.102.s_supplement.012415662794
  • Xhumari A, Rroji A, Enesi E, Bushati T, Sallabanda Diaz K, Petrela M. Glioblastoma after AVM radiosurgery. Case report and review of the literature. Acta Neurochir (Wien). 2015;157(5):889–895. doi:10.1007/s00701-015-2377-925749839
  • Patel TR, Chiang VL. Secondary neoplasms after stereotactic radiosurgery. World Neurosurg. 2014;81(3–4):594–599. doi:10.1016/j.wneu.2013.10.04324148883
  • Yoshida K, Ichikawa T, Kurozumi K, Yanai H, Onoda K, Date I. Fatal glioblastoma after Gamma Knife radiosurgery for arteriovenous malformation in a child. J Clin Neurosci. 2014;21(8):1453–1455. doi:10.1016/j.jocn.2013.10.03924613764
  • Berman EL, Eade TN, Brown D, et al. Radiation-induced tumor after stereotactic radiosurgery for an arteriovenous malformation: case report. Neurosurgery. 2007;61(5):E1099 discussion E1099. doi:10.1227/01.neu.0000303207.92617.4e18091259
  • Kaido T, Hoshida T, Uranishi R, et al. Radiosurgery-induced brain tumor. Case report. J Neurosurg. 2001;95(4):710–713. doi:10.3171/jns.2001.95.4.071011596968
  • Hasegawa H, Hanakita S, Shin M, et al. Re-evaluation of the size limitation in single-session stereotactic radiosurgery for brain arteriovenous malformations: detailed analyses on the outcomes with focusing on radiosurgical doses. Neurosurgery. 2019. doi:10.1093/neuros/nyz280
  • Chung WY, Shiau CY, Wu HM, et al. Staged radiosurgery for extra-large cerebral arteriovenous malformations: method, implementation, and results. J Neurosurg. 2008;109(Suppl):65–72. doi:10.3171/JNS/2008/109/12/S1119123890
  • Ding C, Solberg TD, Hrycushko B, Medin P, Whitworth L, Timmerman RD. Multi-staged robotic stereotactic radiosurgery for large cerebral arteriovenous malformations. Radiother Oncol. 2013;109(3):452–456. doi:10.1016/j.radonc.2013.07.01824021345
  • Firlik AD, Levy EI, Kondziolka D, Yonas H. Staged volume radiosurgery followed by microsurgical resection: a novel treatment for giant cerebral arteriovenous malformations: technical case report. Neurosurgery. 1998;43(5):1223–1228. doi:10.1097/00006123-199811000-001249802869
  • Kano H, Kondziolka D, Flickinger JC, et al. Stereotactic radiosurgery for arteriovenous malformations, Part 6: multistaged volumetric management of large arteriovenous malformations. J Neurosurg. 2012;116(1):54–65. doi:10.3171/2011.9.JNS1117722077447
  • Ilyas A, Chen CJ, Ding D, et al. Volume-staged versus dose-staged stereotactic radiosurgery outcomes for large brain arteriovenous malformations: a systematic review. J Neurosurg. 2018;128(1):154–164. doi:10.3171/2016.9.JNS16157128128692
  • Moosa S, Chen CJ, Ding D, et al. Volume-staged versus dose-staged radiosurgery outcomes for large intracranial arteriovenous malformations. Neurosurg Focus. 2014;37(3):E18. doi:10.3171/2014.5.FOCUS14205
  • Pollock BE, Kline RW, Stafford SL, Foote RL, Schomberg PJ. The rationale and technique of staged-volume arteriovenous malformation radiosurgery. Int J Radiat Oncol Biol Phys. 2000;48(3):817–824. doi:10.1016/S0360-3016(00)00696-911020579
  • Sirin S, Kondziolka D, Niranjan A, Flickinger JC, Maitz AH, Lunsford LD. Prospective staged volume radiosurgery for large arteriovenous malformations: indications and outcomes in otherwise untreatable patients. Neurosurgery. 2006;58(1):17–27. discussion 17–27. doi:10.1227/01.NEU.0000190653.42970.6B16385325
  • Hanakita S, Shin M, Koga T, Igaki H, Saito N. Outcomes of volume-staged radiosurgery for cerebral arteriovenous malformations larger than 20 cm(3) with more than 3 years of follow-up. World Neurosurg. 2016;87:242–249. doi:10.1016/j.wneu.2015.12.02026723283
  • Nagy G, Grainger A, Hodgson TJ, et al. Staged-volume radiosurgery of large arteriovenous malformations improves outcome by reducing the rate of adverse radiation effects. Neurosurgery. 2016. doi:10.1227/NEU.0000000000001212
  • Lindvall P, Bergstrom P, Lofroth PO, et al. Hypofractionated conformal stereotactic radiotherapy for arteriovenous malformations. Neurosurgery. 2003;53(5):1036–1042. discussion 1042–1033. doi:10.1227/01.NEU.0000088566.82699.E614580269
  • Laing RW, Childs J, Brada M. Failure of conventionally fractionated radiotherapy to decrease the risk of hemorrhage in inoperable arteriovenous malformations. Neurosurgery. 1992;30(6):872–875. discussion 875–876. doi:10.1227/00006123-199206000-000091614589
  • Karlsson B, Lindqvist M, Blomgren H, et al. Long-term results after fractionated radiation therapy for large brain arteriovenous malformations. Neurosurgery. 2005;57(1):42–49. discussion 42–49. doi:10.1227/01.NEU.0000163095.56638.26
  • Park HR, Lee JM, Kim JW, et al. Time-staged gamma knife stereotactic radiosurgery for large cerebral arteriovenous malformations: a preliminary report. PLOS ONE. 2016;11(11):e0165783. doi:10.1371/journal.pone.016578327806123
  • Ilyas A, Chen CJ, Ding D, et al. Volume-staged versus dose-staged stereotactic radiosurgery outcomes for large brain arteriovenous malformations: a systematic review. J Neurosurg. 2017;1–11.
  • Chytka T, Liscak R, Kozubikova P, Vymazal J. Radiosurgery for large arteriovenous malformations as a single-session or staged treatment. Stereotact Funct Neurosurg. 2015;93(5):342–347. doi:10.1159/00043911626355435
  • Kano H, Flickinger JC, Nakamura A, et al. How to improve obliteration rates during volume-staged stereotactic radiosurgery for large arteriovenous malformations. J Neurosurg. 2018;1–8.
  • El-Shehaby AMN, Reda WA, Abdel Karim KM, Emad Eldin RM, Nabeel AM, Tawadros SR. Volume-staged Gamma Knife radiosurgery for large brain arteriovenous malformation. World Neurosurg. 2019. doi:10.1016/j.wneu.2019.08.065
  • Franzin A, Panni P, Spatola G, et al. Results of volume-staged fractionated Gamma Knife radiosurgery for large complex arteriovenous malformations: obliteration rates and clinical outcomes of an evolving treatment paradigm. J Neurosurg. 2016;125(Suppl 1):104–113. doi:10.3171/2016.7.GKS16154927903180
  • Huang PP, Rush SC, Donahue B, et al. Long-term outcomes after staged-volume stereotactic radiosurgery for large arteriovenous malformations. Neurosurgery. 2012;71(3):632–643. discussion 643–634. doi:10.1227/NEU.0b013e31825fd24722710381
  • Pollock BE, Link MJ, Stafford SL, Lanzino G, Garces YI, Foote RL. Volume-staged stereotactic radiosurgery for intracranial arteriovenous malformations: outcomes based on an 18-year experience. Neurosurgery. 2017;80(4):543–550. doi:10.1093/neuros/nyw10728362923
  • Seymour ZA, Sneed PK, Gupta N, et al. Volume-staged radiosurgery for large arteriovenous malformations: an evolving paradigm. J Neurosurg. 2016;124(1):163–174. doi:10.3171/2014.12.JNS14130826140495
  • Nagy G, Grainger A, Hodgson TJ, et al. Staged-volume radiosurgery of large arteriovenous malformations improves outcome by reducing the rate of adverse radiation effects. Neurosurgery. 2017;80(2):180–192. doi:10.1227/NEU.000000000000121228173493
  • Oermann EK, Ding D, Yen CP, et al. Effect of prior embolization on cerebral arteriovenous malformation radiosurgery outcomes: a case-control study. Neurosurgery. 2015;77(3):406–417. discussion 417. doi:10.1227/NEU.000000000000077225875580
  • Lee CC, Chen CJ, Ball B, et al. Stereotactic radiosurgery for arteriovenous malformations after Onyx embolization: a case-control study. J Neurosurg. 2015;123(1):126–135. doi:10.3171/2014.12.JNS14143725658780
  • Huo X, Jiang Y, Lv X, Yang H, Zhao Y, Li Y. Gamma Knife surgical treatment for partially embolized cerebral arteriovenous malformations. J Neurosurg. 2015;1–10.
  • Xiaochuan H, Yuhua J, Xianli L, Hongchao Y, Yang Z, Youxiang L. Targeted embolization reduces hemorrhage complications in partially embolized cerebral AVM combined with gamma knife surgery. Interv Neuroradiol. 2015;21(1):80–87. doi:10.1177/INR-2014-1009025934780
  • Schwyzer L, Yen CP, Evans A, Zavoian S, Steiner L. Long-term results of gamma knife surgery for partially embolized arteriovenous malformations. Neurosurgery. 2012;71(6):1139–1147. discussion 1147–1138. doi:10.1227/NEU.0b013e318272028022986603
  • Kano H, Kondziolka D, Flickinger JC, et al. Stereotactic radiosurgery for arteriovenous malformations after embolization: a case-control study. J Neurosurg. 2012;117(2):265–275. doi:10.3171/2012.4.JNS11193522631689
  • Miyachi S, Negoro M, Okamoto T, et al. Embolisation of cerebral arteriovenous malformations to assure successful subsequent radiosurgery. J Clin Neurosci. 2000;7(Suppl 1):82–85. doi:10.1054/jocn.2000.071811013105
  • Miyachi S, Izumi T, Satow T, et al. Effectiveness of preradiosurgical embolization with NBCA for arteriovenous malformations - retrospective outcome analysis in a japanese registry of 73 patients (J-REAL study). Neurointervention. 2017;12(2):100–109. doi:10.5469/neuroint.2017.12.2.10028955512
  • Strauss I, Haim O, Umansky D, et al. Impact of onyx embolization on radiosurgical management of cerebral arteriovenous malformations: treatment and outcome. World Neurosurg. 2017;108:656–661. doi:10.1016/j.wneu.2017.08.18828890009
  • Huo X, Jiang Y, Lv X, Yang H, Zhao Y, Li Y. Gamma Knife surgical treatment for partially embolized cerebral arteriovenous malformations. J Neurosurg. 2016;124(3):767–776. doi:10.3171/2015.1.JNS14271126252461
  • Back AG, Vollmer D, Zeck O, Shkedy C, Shedden PM. Retrospective analysis of unstaged and staged Gamma Knife surgery with and without preceding embolization for the treatment of arteriovenous malformations. J Neurosurg. 2008;109(Suppl):57–64. doi:10.3171/JNS/2008/109/12/S10
  • Yang SY, Kim DG, Chung HT, Paek SH, Park JH, Han DH. Radiosurgery for large cerebral arteriovenous malformations. Acta Neurochir (Wien). 2009;151(2):113–124. doi:10.1007/s00701-008-0173-519209384
  • Nataraj A, Mohamed MB, Gholkar A, et al. Multimodality treatment of cerebral arteriovenous malformations. World Neurosurg. 2014;82(1–2):149–159. doi:10.1016/j.wneu.2013.02.06423454686
  • Darsaut TE, Guzman R, Marcellus ML, et al. Management of pediatric intracranial arteriovenous malformations: experience with multimodality therapy. Neurosurgery. 2011;69(3):540–556. discussion 556. doi:10.1227/NEU.0b013e3182181c0021430584
  • Izawa M, Chernov M, Hayashi M, Iseki H, Hori T, Takakura K. Combined management of intracranial arteriovenous malformations with embolization and gamma knife radiosurgery: comparative evaluation of the long-term results. Surg Neurol. 2009;71(1):43–52. discussion 52–43. doi:10.1016/j.surneu.2007.11.01618291487
  • Xu F, Zhong J, Ray A, Manjila S, Bambakidis NC. Stereotactic radiosurgery with and without embolization for intracranial arteriovenous malformations: a systematic review and meta-analysis. Neurosurg Focus. 2014;37(3):E16. doi:10.3171/2014.6.FOCUS14178
  • Andrade-Souza YM, Ramani M, Scora D, Tsao MN, terBrugge K, Schwartz ML. Embolization before radiosurgery reduces the obliteration rate of arteriovenous malformations. Neurosurgery. 2007;60(3):443–451. discussion 451–442. doi:10.1227/01.NEU.0000255347.25959.D017327788
  • Murray G, Brau RH. A 10-year experience of radiosurgical treatment for cerebral arteriovenous malformations: a perspective from a series with large malformations. Clinical article. J Neurosurg. 2011;115(2):337–346. doi:10.3171/2011.3.JNS1081421548746
  • Schlienger M, Atlan D, Lefkopoulos D, et al. Linac radiosurgery for cerebral arteriovenous malformations: results in 169 patients. Int J Radiat Oncol Biol Phys. 2000;46(5):1135–1142. doi:10.1016/S0360-3016(99)00523-410725623
  • Mathis JA, Barr JD, Horton JA, et al. The efficacy of particulate embolization combined with stereotactic radiosurgery for treatment of large arteriovenous malformations of the brain. AJNR Am J Neuroradiol. 1995;16(2):299–306.7726076
  • Dawson RC 3rd, Tarr RW, Hecht ST, et al. Treatment of arteriovenous malformations of the brain with combined embolization and stereotactic radiosurgery: results after 1 and 2 years. AJNR Am J Neuroradiol. 1990;11(5):857–864.2120988
  • Akakin A, Ozkan A, Akgun E, et al. Endovascular treatment increases but gamma knife radiosurgery decreases angiogenic activity of arteriovenous malformations: an in vivo experimental study using a rat cornea model. Neurosurgery. 2010;66(1):121–129. discussion 129–130. doi:10.1227/01.NEU.0000363154.88768.3420023542
  • Pollock BE, Kondziolka D, Lunsford LD, Bissonette D, Flickinger JC. Repeat stereotactic radiosurgery of arteriovenous malformations: factors associated with incomplete obliteration. Neurosurgery. 1996;38(2):318–324. doi:10.1097/00006123-199602000-000168869059
  • Shtraus N, Schifter D, Corn BW, et al. Radiosurgical treatment planning of AVM following embolization with Onyx: possible dosage error in treatment planning can be averted. J Neurooncol. 2010;98(2):271–276. doi:10.1007/s11060-010-0177-x20383557
  • Miyawaki L, Dowd C, Wara W, et al. Five year results of LINAC radiosurgery for arteriovenous malformations: outcome for large AVMS. Int J Radiat Oncol Biol Phys. 1999;44(5):1089–1106. doi:10.1016/S0360-3016(99)00102-910421543
  • Mohr JP, Parides MK, Stapf C, et al. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet. 2014;383(9917):614–621. doi:10.1016/S0140-6736(13)62302-824268105
  • Magro E, Gentric JC, Darsaut TE, et al. Responses to ARUBA: a systematic review and critical analysis for the design of future arteriovenous malformation trials. J Neurosurg. 2017;126(2):486–494. doi:10.3171/2015.6.JNS1561927128584
  • Ding D, Starke RM, Kano H, et al. Radiosurgery for cerebral arteriovenous malformations in a randomized trial of unruptured brain Arteriovenous Malformations (ARUBA)-eligible patients: a multicenter study. Stroke. 2016;47(2):342–349. doi:10.1161/STROKEAHA.115.01140026658441
  • Pollock BE, Link MJ, Brown RD. The risk of stroke or clinical impairment after stereotactic radiosurgery for ARUBA-eligible patients. Stroke. 2013;44(2):437–441. doi:10.1161/STROKEAHA.112.67023223287780
  • Ding D, Starke RM, Kano H, et al. Stereotactic radiosurgery for ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-Eligible Spetzler-Martin Grade I and II arteriovenous malformations: a multicenter study. World Neurosurg. 2017;102:507–517. doi:10.1016/j.wneu.2017.03.06128344176
  • Tonetti DA, Gross BA, Atcheson KM, et al. The benefit of radiosurgery for ARUBA-eligible arteriovenous malformations: a practical analysis over an appropriate follow-up period. J Neurosurg. 2018;128(6):1850–1854. doi:10.3171/2017.1.JNS16296228665253
  • Hanakita S, Shin M, Koga T, Igaki H, Saito N. Risk reduction of cerebral stroke after stereotactic radiosurgery for small unruptured brain arteriovenous malformations. Stroke. 2016;47(5):1247–1252. doi:10.1161/STROKEAHA.116.01313227073242
  • Karlsson B, Jokura H, Yang HC, et al. The NASSAU (New ASSessment of cerebral Arteriovenous Malformations yet Unruptured) Analysis: are the results from the ARUBA trial also applicable to unruptured arteriovenous malformations deemed suitable for Gamma Knife surgery? Neurosurgery. 2019;85(1):E118–E124. doi:10.1093/neuros/nyy39130295870
  • Soderman M, Pavic L, Edner G, Holmin S, Andersson T. Natural history of dural arteriovenous shunts. Stroke. 2008;39(6):1735–1739. doi:10.1161/STROKEAHA.107.50648518388337
  • van Dijk JM, Terbrugge KG, Willinsky RA, Wallace MC. The natural history of dural arteriovenous shunts: the toronto experience. Stroke. 2009;40(5):e412 author reply e413–414. doi:10.1161/STROKEAHA.108.54532719342606
  • Kwon BJ, Han MH, Kang HS, Chang KH. MR imaging findings of intracranial dural arteriovenous fistulas: relations with venous drainage patterns. AJNR Am J Neuroradiol. 2005;26(10):2500–2507.16286391
  • Hurst RW, Bagley LJ, Galetta S, et al. Dementia resulting from dural arteriovenous fistulas: the pathologic findings of venous hypertensive encephalopathy. AJNR Am J Neuroradiol. 1998;19(7):1267–1273.9726465
  • Cognard C, Casasco A, Toevi M, Houdart E, Chiras J, Merland JJ. Dural arteriovenous fistulas as a cause of intracranial hypertension due to impairment of cranial venous outflow. J Neurol Neurosurg Psychiatry. 1998;65(3):308–316. doi:10.1136/jnnp.65.3.3089728941
  • Lasjaunias P, Chiu M, ter Brugge K, Tolia A, Hurth M, Bernstein M. Neurological manifestations of intracranial dural arteriovenous malformations. J Neurosurg. 1986;64(5):724–730. doi:10.3171/jns.1986.64.5.07243701421
  • van Dijk JM, terBrugge KG, Willinsky RA, Wallace MC. Clinical course of cranial dural arteriovenous fistulas with long-term persistent cortical venous reflux. Stroke. 2002;33(5):1233–1236. doi:10.1161/01.STR.0000014772.02908.4411988596
  • Gandhi D, Chen J, Pearl M, Huang J, Gemmete JJ, Kathuria S. Intracranial dural arteriovenous fistulas: classification, imaging findings, and treatment. AJNR Am J Neuroradiol. 2012;33(6):1007–1013. doi:10.3174/ajnr.A279822241393
  • Borden JA, Wu JK, Shucart WA. A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg. 1995;82(2):166–179. doi:10.3171/jns.1995.82.2.01667815143
  • Cognard C, Gobin YP, Pierot L, et al. Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology. 1995;194(3):671–680. doi:10.1148/radiology.194.3.78629617862961
  • Strom RG, Botros JA, Refai D, et al. Cranial dural arteriovenous fistulae: asymptomatic cortical venous drainage portends less aggressive clinical course. Neurosurgery. 2009;64(2):241–247. discussion 247–248. doi:10.1227/01.NEU.0000338066.30665.B2
  • Zipfel GJ, Shah MN, Refai D, Dacey RG Jr., Derdeyn CP. Cranial dural arteriovenous fistulas: modification of angiographic classification scales based on new natural history data. Neurosurg Focus. 2009;26(5):E14. doi:10.3171/2009.2.FOCUS092819408992
  • Gross BA, Albuquerque FC, McDougall CG, et al. A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas. J Neurosurg. 2018;129(5):1114–1119. doi:10.3171/2017.6.JNS17109029243979
  • Pan DH, Wu HM, Kuo YH, Chung WY, Lee CC, Guo WY. Intracranial dural arteriovenous fistulas: natural history and rationale for treatment with stereotactic radiosurgery. Prog Neurol Surg. 2013;27:176–194.23258522
  • Soderman M, Dodoo E, Karlsson B. Dural arteriovenous fistulas and the role of gamma knife stereotactic radiosurgery: the Stockholm experience. Prog Neurol Surg. 2013;27:205–217.23258524
  • Hanakita S, Koga T, Shin M, Shojima M, Igaki H, Saito N. Role of Gamma Knife surgery in the treatment of intracranial dural arteriovenous fistulas. J Neurosurg. 2012;117(Suppl):158–163. doi:10.3171/2012.7.GKS1296723205804
  • Yang HC, Kano H, Kondziolka D, et al. Stereotactic radiosurgery with or without embolization for intracranial dural arteriovenous fistulas. Neurosurgery. 2010;67(5):1276–1283. discussion 1284–1275. doi:10.1227/NEU.0b013e3181ef3f2220871453
  • Cifarelli CP, Kaptain G, Yen CP, Schlesinger D, Sheehan JP. Gamma knife radiosurgery for dural arteriovenous fistulas. Neurosurgery. 2010;67(5):1230–1235. discussion 1235. doi:10.1227/NEU.0b013e3181eff6f720871448
  • Soderman M, Edner G, Ericson K, et al. Gamma knife surgery for dural arteriovenous shunts: 25 years of experience. J Neurosurg. 2006;104(6):867–875. doi:10.3171/jns.2006.104.6.86716776329
  • Pan DH, Chung WY, Guo WY, et al. Stereotactic radiosurgery for the treatment of dural arteriovenous fistulas involving the transverse-sigmoid sinus. J Neurosurg. 2002;96(5):823–829. doi:10.3171/jns.2002.96.5.082312005389
  • Friedman JA, Pollock BE, Nichols DA, Gorman DA, Foote RL, Stafford SL. Results of combined stereotactic radiosurgery and transarterial embolization for dural arteriovenous fistulas of the transverse and sigmoid sinuses. J Neurosurg. 2001;94(6):886–891. doi:10.3171/jns.2001.94.6.088611409515
  • Pollock BE, Nichols DA, Garrity JA, Gorman DA, Stafford SL. Stereotactic radiosurgery and particulate embolization for cavernous sinus dural arteriovenous fistulae. Neurosurgery. 1999;45(3):459–466. discussion 466–457. doi:10.1097/00006123-199909000-0000810493367
  • Link MJ, Coffey RJ, Nichols DA, Gorman DA. The role of radiosurgery and particulate embolization in the treatment of dural arteriovenous fistulas. J Neurosurg. 1996;84(5):804–809. doi:10.3171/jns.1996.84.5.08048622154
  • Guo WY, Pan DH, Wu HM, et al. Radiosurgery as a treatment alternative for dural arteriovenous fistulas of the cavernous sinus. AJNR Am J Neuroradiol. 1998;19(6):1081–1087.9672015
  • Tonetti DA, Gross BA, Jankowitz BT, et al. Reconsidering an important subclass of high-risk dural arteriovenous fistulas for stereotactic radiosurgery. J Neurosurg. 2018;1–5.
  • Chen CJ, Buell TJ, Diamond J, et al. Stereotactic radiosurgery for high-grade intracranial dural arteriovenous fistulas. World Neurosurg. 2018;116:e640–e648. doi:10.1016/j.wneu.2018.05.06229777886
  • Park KS, Kang DH, Park SH, Kim YS. The efficacy of gamma knife radiosurgery alone as a primary treatment for intracranial dural arteriovenous fistulas. Acta Neurochir (Wien). 2016;158(4):821–828. doi:10.1007/s00701-016-2720-926858208
  • Pan DH, Lee CC, Wu HM, Chung WY, Yang HC, Lin CJ. Gamma Knife radiosurgery for the management of intracranial dural arteriovenous fistulas. Acta Neurochir Suppl. 2013;116:113–119. doi:10.1007/978-3-7091-1376-9_1823417468
  • Starke RM, McCarthy DJ, Chen CJ, et al. Evaluation of stereotactic radiosurgery for cerebral dural arteriovenous fistulas in a multicenter international consortium. J Neurosurg. 2019;1–8.
  • Yang H, Kano H, Kondziolka D, et al. Stereotactic radiosurgery with or without embolization for intracranial dural arteriovenous fistulas. Prog Neurol Surg. 2013;27:195–204.23258523
  • Flickinger JC, Kondziolka D, Pollock BE, Maitz AH, Lunsford LD. Complications from arteriovenous malformation radiosurgery: multivariate analysis and risk modeling. Int J Radiat Oncol Biol Phys. 1997;38(3):485–490. doi:10.1016/S0360-3016(97)89481-39231670
  • Maraire JN, Awad IA. Intracranial cavernous malformations: lesion behavior and management strategies. Neurosurgery. 1995;37(4):591–605. doi:10.1227/00006123-199510000-000018559286
  • Stapleton CJ, Barker FG 2nd. Cranial cavernous malformations: natural history and treatment. Stroke. 2018;49(4):1029–1035. doi:10.1161/STROKEAHA.117.01707429535273
  • Batra S, Lin D, Recinos PF, Zhang J, Rigamonti D. Cavernous malformations: natural history, diagnosis and treatment. Nat Rev Neurol. 2009;5(12):659–670. doi:10.1038/nrneurol.2009.17719953116
  • Dammann P, Jabbarli R, Wittek P, et al. Solitary sporadic cerebral cavernous malformations: risk factors of first or recurrent symptomatic hemorrhage and associated functional impairment. World Neurosurg. 2016;91:73–80. doi:10.1016/j.wneu.2016.03.08027058610
  • Tian KB, Zheng JJ, Ma JP, et al. Clinical course of untreated thalamic cavernous malformations: hemorrhage risk and neurological outcomes. J Neurosurg. 2017;127(3):480–491. doi:10.3171/2016.8.JNS1693427834594
  • Aiba T, Tanaka R, Koike T, Kameyama S, Takeda N, Komata T. Natural history of intracranial cavernous malformations. J Neurosurg. 1995;83(1):56–59. doi:10.3171/jns.1995.83.1.00567782850
  • Moriarity JL, Wetzel M, Clatterbuck RE, et al. The natural history of cavernous malformations: a prospective study of 68 patients. Neurosurgery. 1999;44(6):1166–1171; discussion 1172–1163.
  • Porter RW, Detwiler PW, Spetzler RF, et al. Cavernous malformations of the brainstem: experience with 100 patients. J Neurosurg. 1999;90(1):50–58. doi:10.3171/jns.1999.90.1.005010413155
  • Kondziolka D, Lunsford LD, Kestle JR. The natural history of cerebral cavernous malformations. J Neurosurg. 1995;83(5):820–824. doi:10.3171/jns.1995.83.5.08207472549
  • Mathiesen T, Edner G, Kihlstrom L. Deep and brainstem cavernomas: a consecutive 8-year series. J Neurosurg. 2003;99(1):31–37. doi:10.3171/jns.2003.99.1.003112854740
  • Al-Shahi Salman R, Hall JM, Horne MA, et al. Untreated clinical course of cerebral cavernous malformations: a prospective, population-based cohort study. Lancet Neurol. 2012;11(3):217–224. doi:10.1016/S1474-4422(12)70004-222297119
  • Gross BA, Du R. Cerebral cavernous malformations: natural history and clinical management. Expert Rev Neurother. 2015;15(7):771–777.26098013
  • Cordonnier C, Al-Shahi Salman R, Bhattacharya JJ, et al. Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages: prospective, population-based study. J Neurol Neurosurg Psychiatry. 2008;79(1):47–51. doi:10.1136/jnnp.2006.11375317488785
  • Hasegawa T, McInerney J, Kondziolka D, Lee JY, Flickinger JC, Lunsford LD. Long-term results after stereotactic radiosurgery for patients with cavernous malformations. Neurosurgery. 2002;50(6):1190–1197. discussion 1197–1198. doi:10.1097/00006123-200206000-0000312015835
  • Chang SD, Levy RP, Adler JR, Martin DP, Krakovitz PR, Steinberg GK.Stereotactic radiosurgery of angiographically occult vascular malformations: 14-year experience. Neurosurgery. 1998;43(2):213–220. discussion 220–211.9696072
  • Kida Y, Kobayashi T, Mori Y. Radiosurgery of angiographically occult vascular malformations. Neurosurg Clin N Am. 1999;10(2):291–303. doi:10.1016/S1042-3680(18)30195-510099094
  • Karlsson B, Kihlström L, Lindquist C, Ericson K, Steiner L. Radiosurgery for cavernous malformations. J Neurosurg. 1998;88(2):293–297. doi:10.3171/jns.1998.88.2.02939452238
  • Kida Y, Hasegawa T, Iwai Y, et al. Radiosurgery for symptomatic cavernous malformations: a multi-institutional retrospective study in Japan. Surg Neurol Int. 2015;6(Suppl 5):S249–257. doi:10.4103/2152-7806.15707126005588
  • Park K, Kim JW, Chung HT, Paek SH, Kim DG. Long-term outcome of Gamma Knife radiosurgery for symptomatic brainstem cavernous malformation. World Neurosurg. 2018;116:e1054–e1059. doi:10.1016/j.wneu.2018.05.16429864574
  • Liu HB, Wang Y, Yang S, Gong FL, Xu YY, Wang W. Gamma knife radiosurgery for brainstem cavernous malformations. Clin Neurol Neurosurg. 2016;151:55–60. doi:10.1016/j.clineuro.2016.09.01827794267
  • Lee SH, Choi HJ, Shin HS, Choi SK, Oh IH, Lim YJ. Gamma Knife radiosurgery for brainstem cavernous malformations: should a patient wait for the rebleed? Acta Neurochir (Wien). 2014;156(10):1937–1946. doi:10.1007/s00701-014-2155-024965071
  • Lee CC, Pan DH, Chung WY, et al. Brainstem cavernous malformations: the role of Gamma Knife surgery. J Neurosurg. 2012;117(Suppl):164–169. doi:10.3171/2012.8.GKS12106623205805
  • Lunsford LD, Khan AA, Niranjan A, Kano H, Flickinger JC, Kondziolka D. Stereotactic radiosurgery for symptomatic solitary cerebral cavernous malformations considered high risk for resection. J Neurosurg. 2010;113(1):23–29. doi:10.3171/2010.1.JNS08162620170299
  • Nagy G, Razak A, Rowe JG, et al. Stereotactic radiosurgery for deep-seated cavernous malformations: a move toward more active, early intervention. Clinical article. J Neurosurg. 2010;113(4):691–699. doi:10.3171/2010.3.JNS09115620433275
  • Kida Y. Radiosurgery for cavernous malformations in basal ganglia, thalamus and brainstem. Prog Neurol Surg. 2009;22:31–37.18948717
  • Monaco EA, Khan AA, Niranjan A, et al. Stereotactic radiosurgery for the treatment of symptomatic brainstem cavernous malformations. Neurosurg Focus. 2010;29(3):E11. doi:10.3171/2010.7.FOCUS10151
  • Jacobs R, Kano H, Gross BA, Niranjan A, Monaco EA 3rd, Lunsford LD. Defining long-term clinical outcomes and risks of stereotactic radiosurgery for brainstem cavernous malformations. World Neurosurg. 2018.
  • Sheen JJ, Lee DH, Lee DH, Song Y, Kwon DH. Long-term outcome of gamma knife radiosurgery for brain cavernoma: factors associated with subsequent De Novo Cavernoma formation. World Neurosurg. 2018;120:e17–e23. doi:10.1016/j.wneu.2018.07.04630026166
  • Tu J, Stoodley MA, Morgan MK, Storer KP, Smee R. Different responses of cavernous malformations and arteriovenous malformations to radiosurgery. J Clin Neurosci. 2009;16(7):945–949. doi:10.1016/j.jocn.2008.09.01719342244
  • Nyary I, Major O, Hanzely Z, Szeifert GT. Pathological considerations to irradiation of cavernous malformations. Prog Neurol Surg. 2007;20:231–234. doi:10.1159/00010012217317991
  • Shin SS, Murdoch G, Hamilton RL, et al. Pathological response of cavernous malformations following radiosurgery. J Neurosurg. 2015;123(4):938–944. doi:10.3171/2014.10.JNS1449926090838