{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:54:57Z","timestamp":1786125297250,"version":"build-2736575974"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The management of brainstem arteriovenous malformations (bAVMs) is a formidable challenge. bAVMs harbor higher morbidity and mortality compared to other locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To review the outcomes following stereotactic radiosurgery (SRS) of bAVMs in a multicenter study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Six medical centers contributed data from 205 patients through the International Gamma Knife Research Foundation. Median age was 32 yr (6-81). Median nidus volume was 1.4 mL (0.1-69 mL). Favorable outcome (FO) was defined as AVM obliteration and no post-treatment hemorrhage or permanent symptomatic radiation-induced complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Overall obliteration was reported in 65.4% (n = 134) at a mean follow-up of 69 mo. Obliteration was angiographically proven in 53.2% (n = 109) and on MRA in 12.2% (n = 25). Actuarial rate of obliteration at 2, 3, 5, 7, and 10 yr after SRS was 24.5%, 43.3%, 62.3%, 73%, and 81.8% respectively. Patients treated with a margin dose &gt;20 Gy were more likely to achieve obliteration (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001). Obliteration occurred earlier in patients who received a higher prescribed margin dose (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .05) and maximum dose (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .041). Post-SRS hemorrhage occurred in 8.8% (n = 18). Annual postgamma knife latency period hemorrhage was 1.5%. Radiation-induced complications were radiologically evident in 35.6% (n = 73), symptomatic in 14.6% (n = 30), and permanent in 14.6% (n = 30, which included long-tract signs and new cranial nerve deficits). FO was achieved in 64.4% (n = 132). Predictors of an FO were a higher Virginia radiosurgery AVM scale score (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003), prior hemorrhage (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .045), and a lower prescribed maximum dose (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>SRS for bAVMs results in obliteration and avoids permanent complications in the majority of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyx189","type":"journal-article","created":{"date-parts":[[2017,5,24]],"date-time":"2017-05-24T15:13:00Z","timestamp":1495638780000},"page":"910-920","source":"Crossref","is-referenced-by-count":34,"title":["Stereotactic Radiosurgery for Brainstem Arteriovenous Malformations: A Multicenter Study"],"prefix":"10.1227","volume":"81","author":[{"given":"Or","family":"Cohen-Inbar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Gam-ma-Knife center, University of Virginia, Charlottesville, Virginia"},{"name":"Department of Neurosurgery, Rambam Health Care Center Haifa Israel, Technion Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M","family":"Starke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Gam-ma-Knife center, University of Virginia, Charlottesville, 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