Stereotactic Radiotherapy for Intramedullary Spinal Arteriovenous Malformations

• Published in: Curēus (Palo Alto, CA) Vol. 10; no. 7; p. e2908
• Main Authors: Mori, Yoshimasa, Hashizume, Chisa, Tsugawa, Takahiko, Kato, Sachiko, Shibamoto, Yuta
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 02-07-2018; Cureus
• Subjects: Hardenberg, Georg Philipp Friedrich von (Novalis) (1772-1801); Hemorrhage; Medical imaging; Neurosurgery; NMR; Nuclear magnetic resonance; Patients; Planning; Radiation Oncology; Radiation therapy; Spinal cord; Work stations; arteriovenous malformation; intramedullary; embolisation; venous congestion; paraplegia; stereotactic radiotherapy; tetraplegia; spinal cord; hemorrhage; stereotactic radiosurgery
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.2908

Introduction Preliminary results of stereotactic radiotherapy (SRT) for spinal arteriovenous malformation (AVM) in five cases are presented.  Methods Two cases were male and three were female. Their median age was 32 years (range: 23 to 54 years). The spinal intramedullary AVMs were located in the cervical spine in three and in the thoracic spine in two. SRT with 20 Gy in four fractions was delivered to the nidus in every case. Results At the end of the median follow-up period of 5.5 years (range: 3 to 8.5 years), the neurological symptoms and signs were improved or unchanged as compared with before treatment, although a temporary adverse effect developed between a half year and one year after SRT in one case. The nidi were obliterated five and a half years after SRT in one case and three years after SRT in one. In the other three cases, the nidi were unchanged. Conclusion SRT with 20 Gy in four fractions was thought to be a safe treatment, though this study dealt with only a small number of patients with a short-term follow-up period.