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Case Reports
. 2020 Sep 17;12(3):282-290.
doi: 10.1159/000508943. eCollection 2020 Sep-Dec.

Volume-Staged Radiosurgery for Large Arteriovenous Malformation

Nguyen Thanh Xuan  1 , Pham Nguyen Tuong  2 , Tran Khoa  2 , Pham Nhu Hiep  2 , Nguyen Van Thanh  2 , Dang Hoai Bao  2
Affiliations
Case Reports

Volume-Staged Radiosurgery for Large Arteriovenous Malformation

Nguyen Thanh Xuan et al. Case Rep Neurol. .

Abstract

Large arteriovenous malformations (AVMs) are challenges in management because of outcomes and adverse affects. Volume-staged radiosurgery has been an appropriate approach when removal resection and embolization are not recommended. A 53-year-old gentleman was diagnosed with a large intracranial AVM with persistent headache and short-term seizure. Brain magnetic resonance and angiograph showed a bulky volume of AVM nidus. Removal resection and embolization were not recommended because of high risk of adverse affects. The patient was treated by volume-staged radiosurgery. One year post-treatment, obliteration for right internal carotid artery was completed. Volume-staged radiosurgery is a potential treatment option for large AVM with controlled and obliteration efficacy, especially to AVMs which are not appropriate for removal surgery and embolization.

Keywords: Arteriovenous malformation; Digital subtraction angiography; Volume-staged radiosurgery.

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Conflict of interest statement

The authors declare no financial disclosures or conflicts of interest.

Figures

Fig. 1
Fig. 1
Treatment strategy for AVM.
Fig. 2
Fig. 2
Pre-treatment MRI.
Fig. 3
Fig. 3
Pre-treatment DSA.
Fig. 4
Fig. 4
Whole AVM nidus contouring.
Fig. 5
Fig. 5
Dose volume histogram.
Fig. 6
Fig. 6
MRI before second stage.
Fig. 7
Fig. 7
A Remaining shunts for right internal carotid artery. B Complete obliteration for right external carotid artery. C Complete obliteration for right internal carotid artery.
See this image and copyright information in PMC

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