{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:00:19Z","timestamp":1780736419744,"version":"3.54.1"},"reference-count":134,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>The use of radiosurgery for angiographically occult vascular malformations (AOVMs) is a controversial treatment option for those that are surgically inaccessible or located in eloquent brain. To determine the efficacy of this treatment, the authors reviewed the literature reporting hemorrhage rates, seizure control, and radiation-induced morbidity. They found overall hemorrhage rates of 2\u20136.4%, overall postradiosurgery hemorrhage rates of 1.6\u20138%, and stratified postradiosurgery hemorrhage rates of 7.3\u201322.4% in the period immediately to 2 years after treatment; these latter rates declined to 0.8\u20135.2% &gt; 2 years after treatment. Of 291 patients presenting with seizure across 16 studies, 89 (31%) attained a seizure-free status and 102 (35%) had a reduction in seizure frequency after radiosurgery. Overall radiation-induced morbidity ranged from 2.5 to 59%, with higher complication rates in patients with brainstem lesion locations. Researchers applying mean radiation doses of 15\u201316.2 Gy to the tumor margin saw both low radiationinduced complication rates (0\u20139.1%) and adequate hemorrhage control (0.8\u20135.2% &gt; 2 years after treatment), whereas mean doses \u2265 16.5 Gy were associated with higher total radiation-induced morbidity rates (&gt; 17%). Although the use of stereotactic radiosurgery remains controversial, patients with AOVMs located in surgically inaccessible areas of the brain may benefit from such treatment.<\/jats:p>","DOI":"10.3171\/2009.2.focus0923","type":"journal-article","created":{"date-parts":[[2009,5,1]],"date-time":"2009-05-01T09:57:26Z","timestamp":1241171846000},"page":"E16","source":"Crossref","is-referenced-by-count":28,"title":["Radiosurgery for angiographically occult vascular malformations"],"prefix":"10.3171","volume":"26","author":[{"given":"Martin","family":"Pham","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Feinberg School of Medicine and McGaw Medical Center, Northwestern University, Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard R.","family":"Bendok","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Feinberg School of Medicine and McGaw Medical Center, Northwestern University, Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam A.","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Feinberg School of Medicine and McGaw Medical Center, Northwestern University, Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Hunt","family":"Batjer","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Feinberg School of Medicine and McGaw Medical Center, Northwestern University, Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0260016","series-title":"J Neurol Neurosurg Psychiatry","first-page":"167","article-title":"Clinical presentations of vascular malformations of the brainstem: Comparison of angiographically positive and negative types","volume":"52","author":"Abe","year":"1989"},{"key":"b2-0260016","series-title":"Neurosurg Clin N Am","first-page":"167","article-title":"Radiosurgery using a modified linear accelerator","volume":"3","author":"Alexander","year":"1992"},{"key":"b3-0260016","series-title":"Neurosurgery","first-page":"1229","article-title":"Stereotactic radiosurgery for cavernous malformations: Kjellberg's experience with proton beam therapy in 98 cases at the Harvard cyclotron","volume":"42","author":"Amin-Hanjani","year":"1998"},{"key":"b4-0260016","series-title":"Clin Radiol","first-page":"117","article-title":"Magnetic resonance imaging of intracranial cavernous angiomas: a report of 13 cases with pathological confirmation","volume":"48","author":"Barker","year":"1993"},{"key":"b5-0260016","series-title":"Neurosurgery","first-page":"15","article-title":"Temporal clustering of hemorrhages from untreated cavernous malformations of the central nervous system","volume":"49","author":"Barker","year":"2001"},{"key":"b6-0260016","series-title":"Neurosurgery","first-page":"311","article-title":"Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations","volume":"24","author":"Betti","year":"1989"},{"key":"b7-0260016","series-title":"Clin Neurol Neurosurg","first-page":"179","article-title":"Supratentorial cavernous malformations and epilepsy: seizure outcome after lesionectomy on a series of 35 patients","volume":"99","author":"Cappabianca","year":"1997"},{"key":"b8-0260016","series-title":"Neurosurgery","first-page":"213","article-title":"Stereotactic radiosurgery of angiographically occult vascular malformations: fourteen year experience","volume":"43","author":"Chang","year":"1998"},{"key":"b9-0260016","series-title":"Neurosurg Rev","first-page":"259","article-title":"Lethal recurrent hemorrhages of a brainstem cavernoma","volume":"30","author":"Ciurea","year":"2007"},{"key":"b10-0260016","series-title":"J Neurosurg","first-page":"981","article-title":"Dynamic nature of cavernous malformations: a prospective magnetic resonance imaging study with volumetric analysis","volume":"93","author":"Clatterbuck","year":"2000"},{"key":"b11-0260016","series-title":"J Neurosurg","first-page":"237","article-title":"Seizure outcome after lesionectomy for cavernous malformations","volume":"83","author":"Cohen","year":"1995"},{"key":"b12-0260016","series-title":"Neurosurgery","first-page":"833","article-title":"Linear accelerator radiosurgery of cerebral arteriovenous malformations","volume":"24","author":"Colombo","year":"1989"},{"key":"b13-0260016","series-title":"Neurosurgery","first-page":"14","article-title":"Linear accelerator radiosurgery of cerebral arteriovenous malformations: an update","volume":"34","author":"Colombo","year":"1994"},{"key":"b14-0260016","series-title":"Acta Neurochir Suppl (Wien)","first-page":"92","article-title":"Radiosurgery for vascular malformations of the brain stem","volume":"58","author":"Duma","year":"1993"},{"key":"b15-0260016","series-title":"Neurosurgery","first-page":"605","article-title":"Thrombosed arteriovenous malformations: a type of occult vascular malformation","volume":"23","author":"Ebeling","year":"1988"},{"key":"b16-0260016","series-title":"Neurosurg Clin N Am","first-page":"99","article-title":"Charged-particle radiosurgery for intracranial vascular malformations","volume":"3","author":"Fabrikant","year":"1992"},{"key":"b17-0260016","series-title":"J Neurosurg","first-page":"832","article-title":"Linear accelerator radiosurgery for arteriovenous malformations","volume":"77","author":"Friedman","year":"1992"},{"key":"b18-0260016","series-title":"Neurochirurgie","first-page":"243","article-title":"[Radiosurgery in the treatment of brain cavernomas. 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angiomas","volume":"63","author":"Stea","year":"1994"},{"key":"b58-0260016","series-title":"Neurosurgery","first-page":"260","article-title":"Microsurgical resection of brainstem, thalamic and basal ganglia angiographically occult vascular malformations","volume":"46","author":"Steinberg","year":"2000"},{"key":"b59-0260016","series-title":"Stereotact Funct Neurosurg","first-page":"64","article-title":"Stereotactic helium ion Bragg peak radiosurgery for angiographically occult vascular malformations","volume":"57","author":"Steinberg","year":"1991"},{"key":"b60-0260016","series-title":"Neurosurgery","first-page":"792","article-title":"Angiographically occult vascular malformations: a correlative study of features on magnetic resonance imaging and histological examination","volume":"34","author":"Tomlinson","year":"1994"},{"key":"b61-0260016","series-title":"Int J Radiat Oncol Biol Phys","first-page":"133","article-title":"Stereotactic radiosurgery in the management of angiographically occult vascular malformations","volume":"50","author":"Tsien","year":"2001"},{"key":"b62-0260016","series-title":"J Neurosurg","first-page":"174","article-title":"Recurrent intraparenchymal hemorrhages from angiographically occult vascular malformations","volume":"73","author":"Tung","year":"1990"},{"key":"b63-0260016","series-title":"Neurosurgery","first-page":"1174","article-title":"Correlation of magnetic resonance characteristics and histopathological type of angiographically occult vascular malformations","volume":"44","author":"Vanefsky","year":"1999"},{"key":"b64-0260016","series-title":"Neurosurgery","first-page":"549","article-title":"Angiographically occult angiomas: a report of thirteen cases with analysis of the cases documented in the literature","volume":"17","author":"Wakai","year":"1985"},{"key":"b65-0260016","series-title":"Surg Neurol","first-page":"444","article-title":"Surgical management of brain-stem cavernous malformations: report of 137 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