Open AccessLong‐term control of large pontine arteriovenous malformation using gamma knife therapy: a review with illustrative case
Author(s) -
Mortazavi Martin M.,
Patel Daxa,
Griessenauer Christoph J.,
Tubbs R. Shane,
Fisher Winfield S.
Publication year - 2013
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.149
Subject(s) - medicine , radiosurgery , arteriovenous malformation , gamma knife , radiation therapy , radiology , surgery
Brain stem arteriovenous malformations ( AVMs ) are rare and their clinical management is controversial. A location in highly eloquent areas and a greater risk of radionecrosis are both serious issues for radiosurgery of this entity. We report a case of a pontine AVM treated successfully with gamma knife therapy. At 3 years angiographic follow‐up, imaging demonstrated complete thrombosis and there were no new neurological deficits, and at 7 years clinical follow‐up, the patient continued to be neurologically stable. Although all treatments carry risk of neurological compromise, gamma knife therapy may offer the best treatment option for brain stem AVMs as seen in the case presented herein. This case illustrates a rare case of holo‐pontine AVM tolerating gamma radiation with complete angiographical response and minimal neurological sequalae.