Gamma-Knife Radiosurgery for Intracranial Aneurysm

Jeong, Ho Seok; Kim, Moo Seong; Pyo, Se Young; Jeong, Young Gyun; Lee, Sun Il; Jung, Yong Tae; Sim, Jae Hong; Sim, Hong Bo

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2005;1(2):161-166.
Published online September 30, 2005.

Gamma-Knife Radiosurgery for Intracranial Aneurysm

Ho Seok Jeong, Moo Seong Kim, Se Young Pyo, Young Gyun Jeong, Sun Il Lee, Yong Tae Jung, Jae Hong Sim, Hong Bo Sim

Department of Neurosurgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea Department of Neurosurgery, Ulsan University College of Medicine, Ulsan University Hospital, Ulsan, Korea

Abstract

Objective
The incidence of aneurysm coexisting with on AVM ranges between 2.7 and 16.7%. The anatomical relationship between the AVM and the aneurysm is critical in deciding the best management. As a broad guide, this relationship can be classified as follows: (1) There are aneurysms which are unrelated to the AVM (2) There are aneurysms on the feeding vessels to the nidus, which may be for away from the nidus or dose to it, even within the nidus itself.
Methods
Although radiosurgery has been widely accepted as a method of choice for the treatment of AVMs, the role of radiosurgery for an arterial aneurysm has not been adequately discussed. We have treated 305 AVMs with GK radiosurgery for October, 1994 to December, 2003. Six of 305 patients with AVMs treated by GKRS had an associated aneurysm (1.97%).
Results
Five cases were able to follow-up. Three aneurysms were intranidal aneurysm, two cases were pedicular aneurysm. Male to female ratio were 3 : 2. Mean follow-up period was 35 months. The aneurysm received a mean marginal dose of 18 Gy. Over the next 36 months, 3 aneurysms were completely obliterated. One among the another two aneurysms showed a progressive decrease in size, one aneurysm was disappeared in spite of the decreased the AVM nidus.
Conclusion
Radiosurgery alone may be a method of choice for the treatment of an AVM with an associated intranial aneurysm.

Key Words: AVM, Aneurysm, Radiosurgery.