{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T19:12:59Z","timestamp":1770232379702,"version":"3.49.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>There are few reports of outcomes following stereotactic radiosurgery (SRS) for the management of cerebral cavernous malformations (CCMs) of the basal ganglia or thalamus. Therefore, the authors aimed to clarify these outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Centers participating in the International Radiosurgery Research Foundation were queried for CCM cases managed with SRS from October 2001 to February 2021. The primary outcome of interest was hemorrhage-free survival (HFS) with a secondary outcome of symptomatic adverse radiation events (AREs). Assessment of the association of prognostic factors with HFS was conducted via Kaplan-Meier analysis and log-rank test. Chi-square tests were conducted to assess potential factors associated with the incidence of AREs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Seventy-three patients were identified. The median patient age was 43.5 years (range 4.4\u201379.5 years). Fifty-nine (80.8%) patients had hemorrhage prior to SRS. The median treatment volume was 0.9 cm<jats:sup>3<\/jats:sup> (range 0.07\u201310.1 cm<jats:sup>3<\/jats:sup>) with a median margin prescription dose (MPD) of 12 Gy (range 10\u201320 Gy). One-, 3-, 5-, and 10-year HFS were 93.0%, 89.9%, 89.9%, and 83.0%, respectively, with one hemorrhage-related death approximately 1 year after SRS and nearly 60% and 30% of patients having improvement or stability of symptoms, respectively. There was no correlation between lesion size or MPD and HFS. Seven (9.6%) patients experienced AREs (MPDs &gt; 12 Gy in all cases). Lesion size &gt; 1.0 cm<jats:sup>3<\/jats:sup> was correlated with the incidence of an ARE (p = 0.019). Forty-two (93.3%) of 45 patients treated with an MPD \u2264 12 Gy experienced neither hemorrhage nor AREs following SRS versus 17 (60.7%) of 28 patients treated with an MPD &gt; 12 Gy (p = 0.0006).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>SRS is a reasonable treatment strategy and confers clinical stability or improvement and hemorrhage avoidance in patients harboring CCMs of the basal ganglia or thalamus. An MPD of approximately 12 Gy is recommended for the management of CCM.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.10.jns231894","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T01:22:58Z","timestamp":1702084978000},"page":"1762-1768","source":"Crossref","is-referenced-by-count":6,"title":["Clinical outcomes following stereotactic radiosurgery for cerebral cavernous malformations of the basal ganglia and thalamus"],"prefix":"10.3171","volume":"140","author":[{"given":"Raj","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe","family":"Dumot","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"},{"name":"Department of Neurological Surgery, Civil Hospices of Lyon, France;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Mantziaris","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Dayawansa","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stylianos","family":"Pikis","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yavuz","family":"Samanci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gokce D.","family":"Ardor","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed M.","family":"Nabeel","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Neurosurgery Department, Faculty of Medicine, Benha University, Qalubya, Egypt;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael A.","family":"Reda","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameh R.","family":"Tawadros","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Abdel Karim","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Clinical Oncology, Ain Shams University, Cairo, Egypt;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr M. N.","family":"El-Shehaby","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem M.","family":"Emad Eldin","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrah","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimball","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed H.","family":"Elazzazi","sequence":"additional","affiliation":[{"name":"Extended Modular Program, Faculty of Medicine, Ain Shams University, Cairo, Egypt;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuria","family":"Mart\u00ednez Moreno","sequence":"additional","affiliation":[{"name":"Department of Radiosurgery, R\u00faber International Hospital, Madrid, Spain;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Mart\u00ednez \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Radiosurgery, R\u00faber International Hospital, Madrid, Spain;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Liscak","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaromir","family":"May","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Universit\u00e9 de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Nicolas","family":"Tourigny","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Universit\u00e9 de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjul","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery 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