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Journal of Korean Neurosurgical Society 2003;34(1): 39-44.
Cyst Formation after Gamma Knife Radiosurgery for Cerebral Arteriovenous Malformation.
Wee Hyun Kwon, Moo Seong Kim, Young Gyun Jeong, Sun Il Lee, Yong Tae Jung, Jae Hong Sim
Department of neurosurgery, College of Medicine, Inje University, Busan Paik Hospital, Busan, Korea. 667196@hanmail.net
ABSTRACT
OBJECTIVE
The authors present cases of cyst formation after gamma knife radiosurgery for arteriovenous malformation.
METHODS
One hundred seventy eight arteriovenous malformation patients were treated with Gamma knife radiosurgery from October, 1994 to October, 2002. Six patients developed cyst after Gamma knife radiosurgery after a mean of 46.5 months(range, 11-62 months). Male to female ratio was 5: 1 and mean age was 19.7 years(range, 15-24 years).
RESULTS
The mean marginal dose was 22.7Gy(range, 10-25Gy) and mean volume was 22.4cm3(range, 1.9-80.3cm3). Initial symptoms were hemorrhage in three, seizure in two and headache in one. Symptom after cyst formation was motor weakness in three patients, asymptome in three patients. The locations of the cyst were basal ganglia in two, parietal in two, occipital in one, parietooccipital in one. Ventriculoperitoneal shunt was performed in one, Ommaya's reservoir insertion in one, craniotomy and removal of cyst and then Ommaya's reservoir insertion after 8 months in one and no treatment was given in three.
CONCLUSION
Cyst formation after Gamma knife radiosurgery for arteriovenous malformation may occur. However, symptomatic cysts can be effectively treated with Ommaya's reservoir insertion, or cystoperitoneal shunt and in some cases, excision is needed.
Key Words: Arteriovenous malformation; Cyst formation; Gamma Knife radiosurgery; Treatment method
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