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The actuarial 3 year obliteration rate was 52.2%; 69.4% in cases treated with standard doses (minimum target dose, 18-20Gy), and 14.3% in cases treated with low doses (<18Gy) (p<0.05). Two patients sustained symptomatic radiation injury, but there was no permanent neurological deficit caused by radiosurgery. Five patients had haemorrhage from the AVM after irradiation, including four fatal cases, resulting in a 4.0% annual rate of post-treatment bleeding. Radiosurgery is a viable treatment modality for patients with small deep parenchymal brain stem AVMs. A standard radiosurgical dose is safe and effective when directed to a small treatment volume. However, latent interval haemorrhage remains a significant problem until the nidus is obliterated completely. |
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arteriovenous malformation arteriovenous malformation,brainstem brainstem,vascular malformation of Durett hemorrhages gamma knife therapy malformation,vascular malformation,vascular,treatment of posterior fossa,arteriovenous malformation radiation therapy,CNS treatment and complications with radiation therapy,stereotactic review article treatment of neurologic disorder
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