Oclusión clínica y angiográfica de las malformaciones arteriovenosas cerebrales de difícil acceso tratadas con radiocirugía a 3 años de evolución: estudio definitivo

Salazar, Manuel Hernández; Méndez, Antonio Zarate; López, Luis Ramírez; Gallegos, Alejandro Sosa; Orozco, Armando Fernández; Meza, Moisés Castillo; Parra, Alfredo López; Tapia, Jorge Galicia
January 2007
Archivos de Neurociencias;ene-mar2007, Vol. 12 Issue 1, p6
Academic Journal
Objective: to analyze retrospectively and prospectively, the clinical and angiographic evolution of the patients with the diagnosis of AVM treated with radiosurgery. Methos: between 1998 and 2001, we studied all the patients at the National Medical Center "20 de Noviembre" ISSSTE with the diagnose of cerebral AVM, that counted with clinical and angiographic pursuit by three years, included only 16 patients. The main signs and neurological symptoms relate to the MAV's were valued. The adverse effects to the treatment that were considered, were those that appeared in the interval between the principle of radiosurgery and the obstruction of nidus. All the previous treatment were considered that had a direct influence on the structure of the AVM. Results: the clinical manifestation were: vascular headache in 12 (75%), epeileptic crises in 5 (31.2%), motor deficit in 6 (37.5%) and cranial hypertensive syndrome, in 10 (62.5%. The percentage of distribution according to the SM scale was the following one: 43.7% degree II, 25% degree III, 18.7% degree IV and 18.7% degree V. The dose of treatment was of 19,5 +/- 3 Gy. The average of the percentage of diminution of volume of the AVM to 6 months valued with angiography was of 9,68%, to the 12 months it went of 36%, and to 3 years of 71%. Altogether the 93,1% was improving clinically at the three years of the treatment. Conclusions: we considered that stereotactic radiosurgery is a clinical and radiological treatment acceptable to the cerebral AVM.


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