Efficacy of gamma knife radiosurgery for cerebral cavernous malformations – A single-institution retrospective study

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-09-02 DOI:10.1016/j.jocn.2025.111606

Uyen Truc Gia Dang , Binh Thanh Nguyen , Dat Nguyen Tuong Do , Minh Anh Ho , Phuong Thi Minh Do , Chuong Thanh Huynh , Tu Minh Nguyen , Huy Minh Tran

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引用次数: 0

Abstract

Background

Cerebral cavernous malformations (CCMs) are low-flow vascular malformations of the central nervous system. Although surgical resection is the primary treatment for symptomatic CCMs, gamma knife radiosurgery (GKRS) has been considered as an alternative treatment for CCMs with high surgical risk. This study aims to evaluate outcomes of GKRS in the treatment of CCMs.

Methods

A retrospective study was conducted on 235 patients diagnosed with CCMs who underwent GKRS at Cho Ray Hospital between October 2016 and September 2022. We assessed the annual hemorrhage rate (AHR) after GKRS, seizure control rate, and changes in symptoms after treatment. The mean follow-up duration was 40.34 ± 22.01 months.

Results

The overall post-GKRS AHR was 1.66 % per patient-year, increasing to 4.96 % among patients with brainstem lesions. Hemorrhagic events following GKRS were significantly associated with larger lesion diameters (p = 0.018). Among 43 patients with pre-GKRS epilepsy, 83.7 % achieved favorable seizure control (Engel class I–II). Most patients experienced stable or improved symptoms; worsening occurred in 3.0 % for headache, 2.1 % for dizziness, and 3.4 % for focal neurological deficits. Transient post-GKRS brain edema occurred in 7 patients (3.0 %), all of whom achieved full recovery. No cases of cyst formation were observed.

Conclusions

GKRS is an effective alternative treatment for controlling hemorrhage, reducing seizure rates, and alleviating symptoms for CCMs, particularly those at high surgical risk.

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伽玛刀放射治疗脑海绵状血管瘤的疗效-一项单机构回顾性研究

背景：脑海绵状血管瘤（CCMs）是中枢神经系统的低流量血管畸形。虽然手术切除是症状性CCMs的主要治疗方法，但伽玛刀放射手术（GKRS）已被认为是高风险CCMs的替代治疗方法。本研究旨在评价GKRS治疗CCMs的效果。方法对2016年10月至2022年9月在Cho Ray医院行GKRS的235例确诊为CCMs的患者进行回顾性研究。我们评估了GKRS后的年出血率（AHR）、癫痫控制率和治疗后症状的变化。平均随访时间40.34±22.01个月。结果gkrs后AHR为1.66% /患者年，脑干病变患者AHR为4.96% /患者年。GKRS后出血事件与较大的病变直径显著相关（p = 0.018）。43例gkrs前癫痫患者中，83.7%的患者癫痫发作控制良好（Engel I-II级）。大多数患者症状稳定或改善；3.0%的头痛加重，2.1%的头晕加重，3.4%的局灶性神经功能缺损加重。7例（3.0%）发生短暂性脑水肿，均完全恢复。未见囊肿形成病例。结论sgkrs是一种有效的替代治疗方法，可控制CCMs出血，降低癫痫发作率，缓解CCMs的症状，特别是手术风险高的CCMs。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.