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The thalamic arteriovenous malformations have better prognosis than basal ganglia malformations regarding obliteration: prognostic factors analysis.

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BACKGROUND Arteriovenous malformations are rare vascular congenital lesions that affect mainly patients during their productive years of life. In order to obtain a better quality of life for patients with… Click to show full abstract

BACKGROUND Arteriovenous malformations are rare vascular congenital lesions that affect mainly patients during their productive years of life. In order to obtain a better quality of life for patients with this disease a multidisciplinary approach is recommended. Radiosurgery is one of the treatment modalities available for AVMs, but many factors may influence the effectiveness of this strategy. Classically, it has been said that deep-seated lesions have a particular behavior compared with AVMs in other regions, but a differentiation between thalamic lesions and those located in the basal ganglia has not been made. METHODS Institutional records for central core AVMs treated with radiosurgery between January 2004 and January 2014 were retrospectively analyzed. Brainstem lesions were excluded from the analysis. RESULTS Forty-nine patients with deep-seated AVMs were included. Forty-three (87.8%) were located in the thalamus and six (12.2%) in the area of basal ganglia. The nidus mean volume was 4.1 cm3 (4.1), the maximum diameter mean was of 19.5 mm (8.0). The prescription dose was 18.2 Gy (2.1), and the follow-up time was 75.8 months (32.5). There was a greater obliteration rate in thalamic AVMs compared to those located in the basal ganglia: 81.4% vs 33.3% (p=0.026) respectively. There was no association between categorical variables and obliteration rate. CONCLUSIONS Stereotactic radiosurgery is a good option for patients with thalamic and basal ganglia AVMs but a multidisciplinary approach to decision making is mandatory in order to achieve the best results.

Keywords: basal; obliteration; malformations better; arteriovenous malformations; thalamic arteriovenous; basal ganglia

Journal Title: World neurosurgery
Year Published: 2021

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