Stereotactic Radiosurgery for Unruptured Versus Ruptured Pediatric Brain Arteriovenous Malformations.
Background and Purpose- The effects of prior hemorrhage on stereotactic radiosurgery (SRS) outcomes for pediatric arteriovenous malformations (AVMs) are not well defined. The aim of this multicenter, retrospective cohort study is to compare the SRS outcomes for unruptured versus ruptured pediatric AVMs. Methods- The International Radiosurgery Research Foundation pediatric AVM database from 1987 to 2018 was reviewed retrospectively. Favorable outcome was defined as AVM obliteration, no post-SRS hemorrhage, and no permanently symptomatic radiation-induced changes. Associations between prior hemorrhage and outcomes were adjusted for baseline differences, inverse probability weights, and competing risks. Results- The study cohort comprised 153 unruptured and 386 ruptured AVMs. Favorable outcome was achieved in 48.4% and 60.4% of unruptured and ruptured AVMs, respectively (adjusted odds ratio, 1.353;
Chen CJ, Lee CC, Ding D, Tzeng SW, Kearns KN, Kano H, Atik A, Ironside N, Joshi K, Huang PP, Kondziolka D, Mathieu D, Iorio-Morin C, Grills IS, Quinn TJ, Siddiqui Z, Marvin K, Feliciano C, Faramand A, Starke RM, Barnett G, Lunsford LD, Sheehan JP; International Radiosurgery Research Foundation. Stereotactic Radiosurgery for Unruptured Versus Ruptured Pediatric Brain Arteriovenous Malformations. Stroke. 2019 Oct;50(10):2745-2751. doi: 10.1161/STROKEAHA.119.026211. Epub 2019 Aug 7. PMID: 31387513.