Learn more: https://www.brainlab.com/radiosurgery-products/
Despite the low prevalence—between 0.04% and 0.52%—in the general population, intracranial arteriovenous malformations (AVMs) are the leading cause of nontraumatic intracerebral hemorrhage in people younger than 35 years old. Intracranial AVMs are congenital anomalies developing between the fourth and eighth week of intrauterine life. They consist of the persistence of connections between an artery and a vein without the interposition of a capillary bed, typically under a high-flow regimen.
Problem associated with drug eluting stentPRAVEEN GUPTA
This ppt will tell us about the problem which a cardiologist has to face after implantation of Drug eluting stent in a patient of coronary artery diseases. Although there are lots of problem but i am going to describe only three major problem.
An Overview of Filter-Protected Carotid Artery Stentinggailms
These slides give an overview of cerebral protection devices used today in carotid artery stenting, with special emphasis on distal protection filters. Previous work in the field, results from our laboratory, and future directions of device development are covered.
Neurointerventional Therapy for Brain Aneurysms and Acute Stroke Allina Health
By Yasha Kadkhodayan, MD. Overview of interventional neuroradiology approaches to brain aneurysm and stroke care, discussion of processes in place at Abbott Northwestern to enhance the delivery of stroke care.
Stereotactic Radiotherapy for the Treatment of Acoustic Neuromas Clinical Whi...Brainlab
Learn more: https://www.brainlab.com/radiosurgery-products/
Acoustic neuromas (AN) have an annual incidence of approximately one per 100,000 people and may account for up to 8% of all new tumors presenting to a neurosurgical referral practice. Acoustic neuromas are benign tumors arising from Schwann cells from the vestibular branch of the eighth cranial nerve. Nevertheless, they can pursue a potentially aggressive course, with uncontrolled local growth resulting in compression of the brainstem and fourth ventricle, cranial nerve and other neurological deficits.
Problem associated with drug eluting stentPRAVEEN GUPTA
This ppt will tell us about the problem which a cardiologist has to face after implantation of Drug eluting stent in a patient of coronary artery diseases. Although there are lots of problem but i am going to describe only three major problem.
An Overview of Filter-Protected Carotid Artery Stentinggailms
These slides give an overview of cerebral protection devices used today in carotid artery stenting, with special emphasis on distal protection filters. Previous work in the field, results from our laboratory, and future directions of device development are covered.
Neurointerventional Therapy for Brain Aneurysms and Acute Stroke Allina Health
By Yasha Kadkhodayan, MD. Overview of interventional neuroradiology approaches to brain aneurysm and stroke care, discussion of processes in place at Abbott Northwestern to enhance the delivery of stroke care.
Stereotactic Radiotherapy for the Treatment of Acoustic Neuromas Clinical Whi...Brainlab
Learn more: https://www.brainlab.com/radiosurgery-products/
Acoustic neuromas (AN) have an annual incidence of approximately one per 100,000 people and may account for up to 8% of all new tumors presenting to a neurosurgical referral practice. Acoustic neuromas are benign tumors arising from Schwann cells from the vestibular branch of the eighth cranial nerve. Nevertheless, they can pursue a potentially aggressive course, with uncontrolled local growth resulting in compression of the brainstem and fourth ventricle, cranial nerve and other neurological deficits.
InStent Resetenosis: An Algorithmic Approach to Diagnosis and TreatmentNAJEEB ULLAH SOFI
BMS were developed to mitigate elastic recoil and negative remodeling, but they remain prone to NIH. DES were developed to prevent NIH, and these devices (especially first-generation DES) can be accompanied by delayed reendothelialization, which has been associated with stent thrombosis.
Even in the contemporary era of percutaneous coronary intervention using drug-eluting stents, ISR remains a common problem, occurring in 5% to 20% of cases, depending on several patient and lesion characteristics.
The cumulative rates of DES failure have created a major clinical problem so that > 10% of all PCIs done in the United States are to treat ISR, and the number of ISR interventions appears to be increasing year over year
Stereotactic Radiosurgery and Radiotherapy of Brain Metastases Clinical White...Brainlab
Learn more: https://www.brainlab.com/iplan-rt
Brain metastases are a common manifestation of systemic cancer constituting as much as 30% of all intracranial malignant tumors. Each year, 15 to 30% of cancer patients develop brain metastases, yielding an incidence of over 100,000 patients in the US. Development of brain metastases leads directly to the patient’s death in the majority of cases.
I am a Neurosurgeon with advanced training in Interventional vascular Neurosurgery(FINR) from Zurich, Switzerland, and FMINS-Fellowship in minimally invasive and Endoscopic Neurosurgery from Germany.
I am presently working in Columbia asia hospitals, Bangalore.
My areas of interest are Vascular Neurosurgery, Stroke specialist, interventional neuroradiology, Endoscopic and minimally invasive Neurosurgery, Endoscopic spine surgery.
Arteriovenous Malformations are one of the toughest cerebral pathologies to manage with high post op mortality and morbidity. this powerpoint contains classification, grading and managment of various severity of AVMs
Stereotactic Radiosurgery for the Treatment of Trigeminal Neuralgia Clinical ...Brainlab
Learn more: https://www.brainlab.com/iplan-rt
Trigeminal neuralgia (TN) is well defined and one of the most common causes of facial pain, especially in the elderly. It usually occurs as one-sided, severe, brief, recurrent episodes of spontaneous or stimulation triggered facial pain in the territory of one or more branches of the trigeminal nerve.
Brainlab Cranial Navigation. Efficiently combining decisive aspects of neurosurgery.
Brainlab® Cranial 3.0 provides a new user experience on Kick® and Curve™ navigation platforms. Fully
DICOM-based, cranial navigation and Brainlab Elements* can run parallel with instant synchronization
to update navigated image sets with new fusion results, SmartBrush® objects or trajectories.
Learn more: https://www.brainlab.com/traumacad
TraumaCad® Joints—Automatic Hip Replacement Planning automatically aligns implants to their anatomic landmarks, performs a virtual resection and assembles components at their attachment points to calculate the resulting leg length and offset. Leg Length and Offset Optimization allows the physician to vary the component size and position, and see the impact on leg length and offset on the reduced hip. Post Operative Evaluation determines acetabular cup anteversion and inclination as well as femoral neck shaft version and inclination on the post-op AP X-Ray.
Learn more: https://www.brainlab.com/traumacad
VoyantMark™—Accurately calibrate images and measure patient anatomy. VoyantMark is a single marker X-Ray calibration and marking device. Designed specifically to work with TraumaCad® surgical planning software, VoyantMark aids in accurately measuring patient anatomy—hip, knee, shoulder, ankle and foot.
Learn more: https://www.brainlab.com/elements
Brainlab Elements brings instant access to a suite of radiotherapy pre-planning solutions that work seamlessly together, delivering capability without complexity. Clinicians define the individual elements they need based on their case load, patient need and departmental infrastructure. Brainlab Elements bridge departments and offer working, scalable connections between clinical subspecialties like neurosurgery, spine surgery, orthopedics and radiation oncology. No other company brings it all together like Brainlab.
iPlan BOLD MRI Mapping Clinical White PaperBrainlab
Learn more: https://www.brainlab.com/fibertracking-software
With iPlan BOLD MRI Mapping, anatomical images are enhanced with functional maps showing areas of the brain that are responsible for important motoric or cognitive functions. iPlan BOLD MRI Mapping can be easily combined with iPlan FiberTracking to provide a powerful and comprehensive functional package with information about vital functional areas and significant white matter structures.
Stereotactic Radiosurgery and Radiotherapy of Pituitary Adenomas Clinical Whi...Brainlab
Learn more: https://www.brainlab.com/iplan-rt
Pituitary adenomas (PAs) are the third most common intracranial tumors in surgical practice, accounting for approximately 10 to 25% of all intracranial neoplasms. Radiological series suggest that unsuspected PAs may be present in one out of six people and autopsy specimens reveal a prevalence of 14%. Histopathologically, PAs are mostly benign lesions located on the anterior lobe of the pituitary gland. Because of their invasive growth tendency, these adenomas may cause significant morbidity in affected patients, expressed by visual, endocrinologic and neurologic symptoms.
Monte Carlo Dose Algorithm Clinical White PaperBrainlab
Learn more: https://www.brainlab.com/iplan-rt
Conventional dose calculation algorithms, such as Pencil Beam are proven effective for tumors located in homogeneous regions with similar tissue consistency such as the brain. However, these algorithms tend to overestimate the dose distribution in tumors diagnosed in extracranial regions such as in the lung and head and neck regions where large inhomogeneities exist. Due to the inconsistencies seen in current calculation methods for extracranial treatments and the need for more precise radiation delivery, research has led to the creation and integration of improved calculation methods into treatment planning software.
Stereotactic Radiotherapy of Recurrent Malignant Gliomas Clinical White PaperBrainlab
Learn more: https://www.brainlab.com/intraoperative-mri
Tumors of the central nervous system (CNS) represent approximately 176,000 newly diagnosed cases worldwide per year, with an estimated annual mortality of 128,000. Malignant gliomas comprise 30% of all primary CNS tumors and remain one of the greatest challenges in oncology today, despite access to state-of-the-art surgery, imaging, radiotherapy and chemotherapy.
Learn more: https://www.brainlab.com/iplan-rt
iPlan® Monte Carlo dose calculation offers fast, accurate dose calculations for more precise treatment of extracranial indications—expanding SBRT treatment possibilities. iPlan Monte Carlo performs dose calculations within seconds for conformal beam and dynamic arc treatments and within minutes for complex IMRT cases. Seamless integration allows for use with all major linear accelerators and multi-leaf collimator (MLC) types. This advanced calculation method eliminates treatment area restrictions of conventional dose calculation algorithms for highly precise treatment delivery to inhomogeneous regions including lung and head & neck indications.
Learn more: https://www.brainlab.com/iplan-rt
HybridArc™ intelligently combines two proven, conformal treatment methods for radiosurgery with automated and optimized blending—in seconds—of modulated dynamic conformal arcs and discrete IMRT technology. As part of the iPlan® family of planning and treatment software, HybridArc enables rotational volumetric dose shaping and streamlines both simple and complex treatment planning. Flexible integration makes HybridArc ideal for both the latest advancements in linac technology, as well as established linear accelerators.
Learn more: https://www.brainlab.com/iplan-rt
Less aggressive surgical resection. More functional preservation. Adaptive Hybrid Surgery defines where surgery stops and radiosurgery begins. Today more than half of all cranial benign neoplasms are surgically mitigated with preservation techniques. Combining surgery with radiosurgery offers the best and most durable tumor control while offering the same low surgical risks as preservation surgery on its own.
Learn more: https://www.brainlab.com/quentry
Quentry® is an online service by Brainlab for image transfer, sharing and collaboration. It provides physicians a safe environment to access, control and share diagnostic images and documents. Built on a secure, HIPAA-compliant infrastructure, Quentry supports clinicians throughout the referral, diagnosis, planning and treatment workflow. Physicians can join and connect with each other for free and build a medical referral network, either for individual or hospital use.
Learn more: https://www.brainlab.com/traumacad
VoyantMark is a single marker X-ray calibration and marking device.
Designed specifically to work with TraumaCad® surgical planning software,
VoyantMark aids in accurately measuring patient anatomy— hip, knee, shoulder, ankle and foot.
TraumaCad Orthopedic Digital Templating BrochureBrainlab
Learn more: https://www.brainlab.com/traumacad
TraumaCad® provides orthopedic surgeons with digital tools to perform
preoperative planning and simulates the expected results prior to surgery.
Using digital images on-screen, you can perform measurements, fix prostheses, simulate osteotomies and visualize fracture reductions.
Learn more: https://www.brainlab.com/spinal-navigation
Brainlab Spinal Navigation combines state-of-the-art touch screen based image control with best-in-class registration methods for image-guided surgery. As an open navigation platform, Brainlab Spinal Navigation enables accurate pedicle screw placement as well as drastic reduction of X-Ray exposure to both the surgical team and the patient. Navigation of implants and instruments is possible in 2D images, 3D fluoroscopy scans, MR or CT datasets in all stages of surgery—from incision planning to implant placement.
xSpot Intraoperative Image Registration for C-arm Navigation FlyerBrainlab
Learn more: https://www.brainlab.com/image-registration
xSpot intuitively brings intra-operative C-arm images into navigation. Images taken with xSpot will be automatically registered to fit navigation optimally within the surgical workflow. Brainlab has developed the xSpot for seamless use and navigation in the OR. The autoclavable device is suitable for the sterile environment and is designed for free-hand guidance.
Learn more: https://www.brainlab.com/intraoperative-ultrasound
Brainlab Ultrasound Integration fuses intra-operative ultrasound information with navigated patient data. Brainlab® neuronavigation features live anatomical updates that are overlaid directly onto pre-operative data, offering clinicians advanced resection control and brain shift compensation. Neuronavigation provides ultrasound probe orientation for easy image interpretation. Surgeons are also aided by composite views of intra-operative ultrasound and reformatted CT and MR images.
Learn more: https://www.brainlab.com/microscope-integration
Recognizing that neurosurgeons perform most of their procedures while looking through a microscope and not the navigation screen, Brainlab Cranial Navigation Software supports all major neurosurgery microscopes with improved image integration. Passive markers attached to the microscope enable positional tracking, allowing for ergonomic position orientation, as well as Autofocus on the navigated tool.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Stereotactic Radiosurgery of Arteriovenous Malformations Clinical White Paper
1. STEREOTACTIC RADIOSURGERY OF
ARTERIOVENOUS MALFORMATIONS
Clinical White Paper
Despite the low prevalence—between 0.04% and 0.52%—in the general population 1, intracranial
arteriovenous malformations (AVMs) are the leading cause of nontraumatic intracerebral hemorrhage in
people younger than 35 years old 2. Intracranial AVMs are congenital anomalies developing between the
fourth and eighth week of intrauterine life. They consist of the persistence of connections between an artery
and a vein without the interposition of a capillary bed, typically under a high-flow regimen3. This
entanglement of blood vessels is often called a nidus.
Figure: Details of a typical arteriovenous malformation treatment plan
Intracranial AVMs may present with intracerebral hemorrhage,
seizures, neurologic deficit, headaches or occasionally as
incidental findings on neuroimaging studies4. The risk of
hemorrhage from AVMs without a previous event is about 3%
5
per year . An aggressive therapeutic approach is appropriate for
preventing a fatal intracranial hemorrhaging caused by these
6
lesions .
The goal of AVM treatment should be complete removal or
obliteration of the nidus, while preserving the functionality of the
adjacent brain tissue. The successful treatment of AVMs
remains a challenge with current options, including
microsurgical resection, embolization and stereotactic
7
radiosurgery (SRS) . The adequate use of each of these tools
as a single or combined treatment modality is necessary to
successfully complete the treatment.
As the traditional treatment modality, microsurgical resection is
an effective method to quickly eliminate the risk of hemorrhage8.
However, large lesions in deep, eloquent regions of the brain
are not amenable to microsurgery because of associated
morbidity and mortality. Adjuvant embolization is also useful in
the treatment of AVMs, but the associated risks can be high and
9
the long-term efficacy of the treatment is not well understood .
There may be a risk of recanalization after embolization, even
with recent novel materials.
Over the years, SRS has provided an elegant means of
10-17
. Because AVM tissue responds
safely treating AVMs
slowly to radiation, several months may follow SRS
treatments before complete nidus obliteration18. The
significant risk of hemorrhage during this latency period
mandates diligent neuroimaging follow-up of the
radiosurgical patients until complete obliteration of the nidus
19
is angiographically confirmed .
Several imaging modalities, such as digital subtraction
angiography (DSA), computerized tomography angiography
(CTA), magnetic resonance angiography (MRA) or
combinations of these, may be used to create images of the
nidus for SRS target definition. Despite the major
disadvantage of being a two-dimensional imaging technique,
DSA remains the gold standard for AVM imaging because it
provides unique temporal information.
A summary of the most important SRS treatment
parameters, together with the expected outcome of some
dedicated SRS studies of the treatment of intracranial AVMs,
is presented in the table below. A recent experience on
17
repeat SRS for large AVMs is also included .
Hypofractionation trials for the stereotactic radiotherapy
treatment of intracranial AVMs are currently underway;
however, the results are still preliminary and are therefore
not included.
2. In general, patients are immobilized with a frame and a single
mean dose of 15 to 19 Gy is prescribed to the 80% isodose
line. The dose is typically delivered by four to eight arcs—for
spherical lesions, conical collimators can be preferred over
high-resolution multi-leaf collimators.
The overall incidence of radiation-induced complications
ranges from 3 to 6% and the reported neurological deficits
10-17
.
are often of transient nature
It is therefore concluded that SRS is a safe and effective
intracranial AVM treatment option, as long as careful
neuroimaging follow-up is guaranteed to monitor the nidus
response.
Intracranial AVMs are often classified according to a grading
20
score developed by Spetzler and Martin and the prescribed
dose is related to the initial AVM grade, since complete nidus
obliteration rates were found to depend mainly on the AVM
11,13,15
.
volume and the SRS dose
Overview of the recent clinical literature on SRS for arteriovenous malformations
Institution
Pedroso
Buis
12
Scarbrough
14
Zabel-du Bois
Huang
13
16
MorenoJiménez
Raza
10
17
% Prior
Treatment
Mean Vol
(cm³)
Mean
Dose (Gy)
#
Fractions
% IDL
covering
PTV
% Complete
Obliteration
1999
50
36
23
16
1
80
45 at 20 months
2004
44
30
18
15
1
80
52 at 37 months
VU University Medical
Center, Amsterdam
15
#
Lesions
David Geffen School of
Medicine, Los Angeles
11
Mobin
Year
University of California,
Davis
Author
2005
31
32
3
19
1
80
77 at 33 months
The Melbourne Cancer
Center, Melbourne
2005
39
8
7
17
1
80
87 at 24 months
University of Heidelberg
2006
22
36
4
18
1
80
65 at 48 months
Ghang Gung Memorial
Hospital, Taiwan
2006
34
14
2
16
1
80
NA
Nat´l Institute of Neurol &
Neurosurg, Mexico
2007
40
40
8
15.4
1
80
63 at 29 months
The Johns Hopkins
Hospital, Baltimore
2007
14
47
25
36
3
NA
36 at 31 months
Complete obliteration implies that the nidus is no longer visible angiographically and that the circulation time and the afferent and efferent vessels that had supplied
the malformation have returned to normal. For angiographically occult lesions like low-flow cavernous malformations, studied by Huang et al., there is currently no
gold standard for demonstrating the obliteration.
References
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[3]
[4]
[5]
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[7]
[8]
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[10]
Pollock B.E. et al., Stroke 27, 1, 1996
Karhunen P.J. et al., Forensic Sci Int 48, 9, 1990
Fleetwood I.G. et al., Lancet 359, 863, 2002
Thompson R.C. et al., Neurosurgery 43, 202, 1998
Nussbaum E.S. et al., Neurosurgery 43, 347, 1998
Sasaki T. et al., J Neurosurg 88, 285, 1998
Ellis T.L. et al., J Neurosurg 89, 104, 1998
Lawton M.T., Neurosurg 52, 740, 2003
Yu S.C. et al., AJNR Am J Neuroradiol 25, 1139, 2004
Moreno-Jiménez S. et al., Surg Neurol 67, 487, 2007
Europe | +49 89 99 1568 0 | de_sales@brainlab.com
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RT_WP_E_AVM_APR11
[11]
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Mobin F. et al., Stereotact Funct Neurosurg 73, 50, 1999
Buis D.R. et al., Int J Radiat Oncol Biol Phys 62(1), 246, 2005
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