The Impact of Arteriovenous Malformation Radiosurgery on the Brain: From Morphology and Perfusion to Neurocognition

Guo, Wan‐Yuo; Lee, S.M.; Chang, Yue‐Cune; Pan, H.C.

doi:10.1159/000094955

Cited by 14 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This was not emphasized in the results because various reports in the literature show minimal sequelae of stereotactic radiosurgery treatment on cognitive function. [23][24][25] Patients in a poor clinical state after initial hemorrhage, or as a result of active treatment, were not evaluated. In our opinion, neuropsychological testing is a fine tool that can be used to measure and compare outcomes.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological Performance after Brain Arteriovenous Malformations Treatment

Bradáč

Pulkrabkova

Lacy

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

The treatment of brain arteriovenous malformations (AVMs) has been studied extensively. With the use of the Spetzler-Martin (S-M) grading system, patients can be informed appropriately about their possible surgical risks. This does not hold true for their neuropsychological sequelae, which have not been studied widely. We evaluated the neuropsychological outcome of our patients treated for brain AVMs. Of 113 patients treated for a brain AVM between 2001 and 2009, 66 patients were enrolled in the study. All patients underwent treatment at our institution and neuropsychological testing 2 years later using a test battery constructed specifically for this study. A control group consisted of 10 subjects without any neurologic disease. When the whole cohort was analyzed, no significant differences were found between the groups distinguished by hemorrhage, gender, or hemispheric dominance. Patients with S-M IV and V scores fared significantly worse than patients with S-M I to III. Patients who presented with epilepsy scored lower than patients presenting with other symptomatology, but the difference had only borderline significance. When we analyzed patients according to the presence or absence of obliteration after treatment and compared these with the control group, we found no significant differences. When the patients with an obliterated AVM after treatment were subdivided according to treatment modality, there were no significant differences in their S-M groups compared with the control group. Similarly, those patients with nonobliterated AVMs analyzed according to their S-M grade showed a borderline significant difference, with S-M IV and V having a worse neuropsychological outcome compared with the other groups. Patients harboring nonobliterated high-grade AVMs (S-M IV and V) scored worse than patients with nonobliterated AVM S-M grades I to III. This could be explained by the steal phenomenon. No differences in neuropsychological testing were found when comparing results according to nidus location. This study lends support to an active treatment policy for cerebral AVMs. Those patients in whom complete obliteration was achieved with treatment scored similarly to the background population, implying active AVM treatment does not cause deterioration in neuropsychological performance. This, together with a> 90% AVM obliteration rate, favors microsurgery as the treatment modality of choice whenever the AVM can be safely resected.

show abstract

Section: Discussionmentioning

confidence: 99%

Neuropsychological Performance after Brain Arteriovenous Malformations Treatment

Bradáč

Pulkrabkova

Lacy

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

show abstract

“…A case series which included three pre-adolescents (age 10 and 11) and two adolescents (age 15), considered to be cognitively intact before AVM discovery, showed that regardless of the AVM location, mild to moderate executive dysfunction was evident after surgical excision of the AVM (Whigham and O'Toole 2007). In contrast, a study on neurocognition and radiosurgery in adults (N=34) demonstrated that AVM patients improved significantly (p<0.001) on the Wisconsin Card Sorting Test (WCST) after radiosurgical treatment (Guo et al 2006). Because executive functions are thought to develop during adolescence, Whigham and O'Toole suggested that AVM treatment in their adolescent patients may help explain the vulnerability towards executive dysfunction after AVM treatment.…”

Section: Neurological/neuropsychological Deficitsmentioning

confidence: 99%

Neuropsychological Effects of Brain Arteriovenous Malformations

Lantz

Meyers

2008

Neuropsychol Rev

View full text Add to dashboard Cite

Brain arteriovenous malformations (AVM's) are developmental, chronic lesions that provide unique information about the human brain and can be a useful model for neuroscientists to study cerebral reorganization and hemodynamics. We review the neuroanatomy, epidemiology, natural history, imaging and treatment of brain AVMs, and provide a model with which to better understand neuropsychological functioning and brain reorganization. We suggest that future studies must exclude ruptured AVMs if they wish to further explain focal neurological/cognitive deficits associated with this neurovascular anomaly.

show abstract

“…Very few studies have addressed the issue of the possibility of cognitive dysfunction in patients who undergo radiosurgery. [ 6 7 8 9 10 ] The present study evaluated a cohort of patients with brain AVMs prospectively and compared the pretherapeutic neuropsychological scores with 2 years posttreatment scores. To the best of our knowledge, this study represents one of the largest series where cognitive outcome after 2 years of patients with AVMs treated with gamma knife radiosurgery (GKRS) has been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Impact on cognitive functions following gamma knife radiosurgery for cerebral arteriovenous malformations

Avanali

Bennett

Arivazhagan

et al. 2016

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

Background:Radiosurgery is an alternative to surgical resection of arteriovenous malformation (AVM). Very few studies have addressed the concern of radiation injury to the brain and its attendant adverse effects on cognitive function.Materials and Methods:This prospective study included all patients who underwent gamma knife radiosurgery (GKRS) at our institute for cerebral AVM between 2006 and December 2008 (n = 34). All patients underwent neuropsychological evaluation before the procedure. Neuropsychological evaluation was repeated in eighteen patients 2 years following GKRS. Clinical outcome, AVM obliteration, and factors influencing outcome were analyzed in these eighteen patients.Results:Before GKRS, more than 50% had significant impairment of neuropsychological functions compared to normal population norms. 66.6% achieved the excellent radiosurgical outcome. At 2 years follow-up, patients showed varied improvement in neuropsychological function in various categories. Pretherapeutic median value for percentage perseverative responses was 26.5 and at follow-up, it reduced to 18.2 (P = 0.039). Set shifting improved in 11 patients (61.1%), remained same in 5 patients (27.7%), and deteriorated in two patients (11.1%). Patients with a higher Spetzler-Martin grade AVM demonstrated a significantly more favorable shift in follow-up test values for set shifting function (P = 0.021). Patients with postradiation imaging changes had lesser tendency to improve in neuropsychological performance at follow-up.Conclusions:GKRS has no clinically harmful effect on cognitive and neuropsychological functioning in patients with brain AVM. On the contrary, there is an improvement in majority of patients at 2 years following radiosurgery when nidus is obliterated.

show abstract

The Impact of Arteriovenous Malformation Radiosurgery on the Brain: From Morphology and Perfusion to Neurocognition

Cited by 14 publications

References 16 publications

Neuropsychological Performance after Brain Arteriovenous Malformations Treatment

Neuropsychological Performance after Brain Arteriovenous Malformations Treatment

Neuropsychological Effects of Brain Arteriovenous Malformations

Impact on cognitive functions following gamma knife radiosurgery for cerebral arteriovenous malformations

Contact Info

Product

Resources

About