{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:50:14Z","timestamp":1789195814725,"version":"build-2803163510"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Arteriovenous malformations (AVMs) of the posterior fossa have an aggressive natural history and propensity for hemorrhage. Although the cerebellum accounts for the majority of the posterior fossa volume, there is a paucity of stereotactic radiosurgery (SRS) outcome data for AVMs of this region. The authors sought to evaluate the long-term outcomes and risks of cerebellar AVM radiosurgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This single-institution retrospective analysis reviewed the authors' experience with Gamma Knife surgery during the period 1987\u20132007. During this time 64 patients (median age 47 years, range 8\u201375 years) underwent SRS for a cerebellar AVM. Forty-seven patients (73%) presented with an intracranial hemorrhage. The median target volume was 3.85 cm<jats:sup>3<\/jats:sup> (range 0.2\u201312.5 cm<jats:sup>3<\/jats:sup>), and the median marginal dose was 21 Gy (range 15\u201325 Gy).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Arteriovenous malformation obliteration was confirmed by MRI or angiography in 40 patients at a median follow-up of 73 months (range 4\u2013255 months). The actuarial rates of total obliteration were 53% at 3 years, 69% at 4 years, and 76% at 5 and 10 years. Elevated obliteration rates were statistically higher in patients who underwent AVM SRS without prior embolization (p = 0.005). A smaller AVM volume was also associated with a higher rate of obliteration (p = 0.03). Four patients (6%) sustained a hemorrhage during the latency period and 3 died. The cumulative rates of AVM hemorrhage after SRS were 6% at 1, 5, and 10 years. This correlated with an overall annual hemorrhage rate of 2.0% during the latency interval. One patient experienced a hemorrhage 9 years after confirmed MRI and angiographic obliteration. A permanent neurological deficit due to adverse radiation effects developed in 1 patient (1.6%) and temporary complications were seen in 2 additional patients (3.1%).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Stereotactic radiosurgery proved to be most effective for patients with smaller and previously nonembolized cerebellar malformations. Hemorrhage during the latency period occurred at a rate of 2.0% per year until obliteration occurred.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.9.jns131022","type":"journal-article","created":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T14:27:00Z","timestamp":1382711220000},"page":"583-590","source":"Crossref","is-referenced-by-count":29,"title":["Stereotactic radiosurgery for arteriovenous malformations of the cerebellum"],"prefix":"10.3171","volume":"120","author":[{"given":"Greg","family":"Bowden","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"the Center for Image-Guided Neurosurgery,"},{"name":"Departnemt of Neurological Surgery, University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Kano","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"the Center for Image-Guided Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Tonetti","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"the Center for Image-Guided Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Radiation Oncology and"},{"name":"the Center for Image-Guided Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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