AJDRAJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 2009;30:109.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1240

INTERVENTIONAL

Embolization of Residual Fistula Following Stereotactic Radiosurgery in Cerebral Arteriovenous Malformations

T.J. Hodgson, A.A. Kemeny, A. Gholkar and N. Deasy

From the National Department of Stereotactic Radiosurgery/Department of Radiology (T.J.H., A.A.K.), Royal Hallamshire Hospital, Sheffield, UK; Department of Neuroradiology (A.G.), Newcastle General Hospital, Newcastle-upon-Tyne, UK; and Department of Neuroradiology (N.D.), King's College Hospital, London, UK.

Please address correspondence to Timothy J. Hodgson, MD, National Department of Stereotactic Radiosurgery/Department of Radiology, Royal Hallamshire Hospital, Glossop Rd, Sheffield S10 2JF, UK; e-mail: tim.hodgson{at}sth.nhs.uk

SUMMARY: Treatment of brain arteriovenous malformations (BAVMs) often requires a multitechnique approach. We present 2 cases of BAVM, in which initial stereotactic radiosurgery (SRS) was successful in obliterating a significant volume of the nidus. At follow-up angiography, residual fistulas were identified and selectively embolized; this procedure cured the lesions. Many series describe initial embolization to reduce the nidal volume followed by SRS to the remnant. The described cases highlight the value of primary radiosurgery followed by selective fistula embolization.






Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X