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. 2020;6(4):269-275.

Stereotactic radiosurgery for thalamus arteriovenous malformations

Mohameth Faye  1   2 , Moussa Diallo  2 , Manal Sghiouar  3 , Elhadji Cheikh Ndiaye Sy  2 , Pierre Yves Borius  1 , Jean-Marie Régis  1
Affiliations

Stereotactic radiosurgery for thalamus arteriovenous malformations

Mohameth Faye et al. J Radiosurg SBRT. 2020.

Abstract

Background: Cerebral arteriovenous malformations or angiomas are congenital vascular anomalies defined by abnormal arteriovenous shunt.

Materials and methods: We conducted a retrospective study between January 1992 and December 2010 at the Timone Hospital radiosurgery unit, 1557 patients were treated by radiosurgery for arteriovenous malformation of which 53 for thalamic localization (3,4%).

Results: The mean age was 35.8-/+16.6 years (4-75). 14 patients underwent pre-radiosurgical embolization (26.4%), discovery mode for 47 patients (88.7%) was haemorrhage. The average treatment volume was 1.43 cm3. The average RBAS score was 1.36. The average prescription to the 50% isodose envelope delivered was 22.9 +/-2.9 Gy (12-30), the median margin dose was 24 Gy. Our global obliteration rate after one or two procedures 66.7% for an average follow-up period of 56.7 months. We noted 3.9% of mortality, 5.9% of bleeding after procedure and 3.9% of radio-induced neurological deficit.

Conclusion: Radiosurgery became indispensable in the treatment of thalamic AVM even when there is a persistent risk of haemorrhage until total recovery.

Keywords: arteriovenous malformations; radiosurgery; thalamus.

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Conflict of interest statement

Authors’ disclosure of potential conflicts of interest The authors have nothing to disclose.

Figures

Figure 1
Figure 1
Brain imaging of a 66-year-old patient at the time of treatment : a) Axial CT angiography showing an aspect in favour of a right thalamic AVM fed by one of the branches of the posterior cerebral artery ; b) TOF MRA with coronal reconstitution at the arterial phase showing a right thalamic AVM ; c) Stereotactic cerebral angiography of the right vertebral artery: a right thalamic AVM fed by the posterior choroidal artery with deep venous drainage; d) Cerebral angiography of the right vertebral artery with 3D reconstruction illustrating a right thalamic AVM fed by the posterior choroidal artery with deep venous drainage.
Figure 2
Figure 2
Cerebral angiography of the right vertebral artery during treatment and 3 years later: a) Stereotactic cerebral angiography of the right vertebral artery during treatment (right thalamic AVM fed by the posterior choroidal artery with deep venous drainage) ; b) cerebral angiography of the right vertebral artery 3 months after treatment: normal.
Figure 3
Figure 3
Obliteration and post SRS haemorrhage curves.
See this image and copyright information in PMC

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