J. Abdullah, Ibrahim L, A.R. Ariff, N.
Marzuki
Neurosurgical Division, Department of
Radiology,
School of Medical Sciences, Universiti
Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Radiosurgery for the management of vascular malformation (AVM) and Acoustic Neuromas are increasing in popularity for lesions with diameters less than 3.5cm. We review radiological changes of two cases of who received Gamma Knife therapy in Hospital USM. The first case an Acoustic Neuroma treated in Japan and the second an AVM treated in Singapore. Respectively in the first case, there was no change of volume after 3 years with mild central necrotic changes. In the second case mild radiation necrosis was only seen after 1 year.
The literature is reviewed to correlate the success of radiosurgery in the management of arteriovenous malformation in eloquent areas as well as Acoustic Neuromas as well as the expected Magnetic resonance imaging changes.
Result: Literature review indicates varying success in various centers for both pathologies. For Acoustic Neuromas success rate varied from 54% to 97%. Success rate for arteriovenous malformation ranged from 60% to 74%.
Conclusion: Radiosurgery is an alternative to operative Neurosurgery for small lesions and should be available in the East Coast of Malaysia with a ratio of one machine for 5 million people.
Reference:
1. Lundsford LD, Kondziolka D, Maitz A
et al. Blackholes, white drafts and supernovas: imaging after radiolsurgery.
Stereotactic Funct. Neurosurg 1998;70(Suppl. 1):2-10.
2. Yammamoto M, Hara M, Ide M et al: Radiation-related
adverse effects al observed on Neuro-imaging several years after radiosurgery
for cerebral artery venous malformations. Surg Neurol 1998;49(4):385-97.
3. Kobayashi T, Tanaka T, Kida Y. The
early effects of Gamma on 40 cases of acoustic Neuriroma. Acta Neurochir
Suppl(Wien) 1994;62:93-7.
4. Hirato M, Inoue H, Zama A et al. Gamma
Knife radiosurgery for acoustic schwannoma: effects of low radiation dose
and functional progrosis. Stereotact Funct. Neurosurg 1996;66(Suppl 1):134-41.