Cerebral arteriovenous malformations have been most gratifying lesions to manage with Gamma Knife surgery. The treatment was started by Professor Ladislau Steiner, at the Karolinska Institute in Stockholm, in 1970 and since that time he has treated over 600 patients with very good results. However, the variability of the lesions and the size limitations imposed by brain tolerance to radiation make it impossible to offer Gamma Knife surgery to all patients with an arteriovenous malformation. Indeed, Steiner emphasises, in the Leksell tradition, that the Gamma Knife user must also be adequately expert in the surgical removal of the lesions he is treating. Moreover, the introduction of improvements in angiographic catheters, with corresponding improvements in embolization techniques means that a variety of treatments are available: thus, the treatment chosen should be tailored to the patient’s needs. Moreover, the different treatment methods may be combined to provide optimal management. In consequence, cooperation between departments and across speciality boundaries is an important aspect of the management of this condition.
KeywordsArteriovenous Malformation Gamma Knife Proton Beam Therapy Gamma Knife Surgery Cavernous Angioma
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Suggested Further Reading
- 4.Kihlström L, Lindquist C, Adler J, Collins P, Karlsson B (1992) Histological studies of gamma knife lesions in normal and hypercholesterolemic rabbits. In: Steiner L (ed) Radiosurgery, baselines and trends. Raven Press, New York, pp 111–121Google Scholar