Türk Nöroşirürji Dergisi 2002 , Vol 12 , Num 2
Türker KILIÇ1, Selçuk PEKER1, Deniz KONYA1, Feyyaz BALTACIOĞLU3, Meriç ŞENGÖZ2, M, Necmettin PAMİR1
1Marmara Üniversitesi Tıp Fakültesi Nöroşirürji, Anabilim Dalı İstanbul
2Marmara Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi, Anabilim Dalı İstanbul
3Marmara Üniversitesi Tıp Fakültesi Radyoloji, Anabilim Dalı İstanbul
1: "Summary Aim: Gamma-Knife Radiosurgery (GKRS) has been used in gradually increasing insidence in the treatment of cerebral arteriovenous malformation (AVM), having nidus diameter less than 40mm. This treatment, which avoids drawbacks of surgical invasiveness and general anesthesia, cures the AVM by resulting in obliteration of AVM caused by proliferation of endothelial cells. In this report, the effectiveness of CKRS performed by Marmara University Gamma-Knife Center in the first 126 AVM patients, who completed 2 year follow-up, is presented.

Material and Method: In this prospective study, clinical and angiographic results, concluded in the end of 2nd year follow-up of AVM patients are presented. All patients have been treated by GKRS at Marmara University, İstanbul, Turkey.

Results: In 95% (120/126) of all patients, reduction in nidus size was detected. In 86% (103/126), reduction in nidus size reached to complete obliteration. In 6% (15/126) a 50-80% reduction in nidal volume and in 1.6%( (2/126) detection of only a venous drainage but the nidus were concluded. In the end of two years 6 patients (5%) revealed no change in the nidal volume. The combined rate of complications plus hemorrhage in the first 2 years was calculated to be 7%, and mortality rate in the same period was 0.8%.

Conclusion: It is concluded that in the management of AVM's those are geometrically suitable for CKRS, microsurgery should be the treatment of choice instead of GKRS only if the expected surgical morbidity and mortality are less than 7% and 1 % respectively. Anahtar Kelimeler : Arteriovenous malformation, Gamma-Knife, radiosurgery, stereotaxy