LINAC Stereotactic Radiosurgery for brain arteriovenous malformation: a single institutional experience from Saudi Arabia

Fareed, Muhammad Mohsin; Amro, Abdullah; Bayoumi, Yasser; Orz, Yasser; Tunio, Mutahir A.; Maklad, Ahmad; Riaz, Khalid

doi:10.7243/2052-6946-1-1

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…19 However, the postradiosurgical response of a cerebral AVM is highly variable, with complete obliteration seen as early as a few months, as late as 5 years, or not at all during the follow-up period. 2,6 The cause of obliteration of AVM-associated aneurysms has been speculated to be related to reduction in blood flow and pressure, leading to adjacent feeding artery aneurysm obliteration. This high-flow hypothesis considers that reductions in AVMassociated blood flow and the pulsatile shear stress result in concomitant aneurysm disappearance.…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife radiosurgery of saccular aneurysms in a rabbit model

Meadowcroft¹,

Cooper

Rupprecht³

et al. 2018

Journal of Neurosurgery

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OBJECTIVE Intracranial aneurysms are vascular abnormalities associated with neurological morbidity and mortality due to risk of rupture. In addition, many aneurysm treatments have associated risk profiles that can preclude the prophylactic treatment of asymptomatic lesions. Gamma Knife radiosurgery (GKRS) is a standard treatment for trigeminal neuralgia, tumors, and arteriovenous malformations. Aneurysms associated with arteriovenous malformations have been noted to resolve after treatment of the malformation. The aim of this study was to determine the efficacy of GKRS treatment in a saccular aneurysm animal model. METHODS Aneurysms were surgically produced using an elastase-induced aneurysm model in the right common carotid artery of 10 New Zealand white rabbits. Following initial observation for 4 years, each rabbit aneurysm was treated with a conformal GKRS isodose of 25 Gy to the 50% margin. Longitudinal MRI studies obtained over 2 years and terminal measures obtained at multiple time points were used to track aneurysm size and shape index modifications. RESULTS Aneurysms did not rupture or involute during the observation period. Whole aneurysm and blood volume averages decreased with a linear trend, at rates of 1.7% and 1.6% per month, respectively, over 24 months. Aneurysm wall percent volume increased linearly at a rate of 0.3% per month, indicating a relative thickening of the aneurysm wall during occlusion. Nonsphericity of the average volume, aspect ratio, and isoperimetric ratio of whole aneurysm volume all remained constant. Histopathological samples demonstrated progressive reduction in aneurysm size and wall thickening, with subintimal fibrosis. Consistent shape indices demonstrate stable aneurysm patency and maintenance of minimal rupture risk following treatment. CONCLUSIONS The data indicate that GKRS targeted to saccular aneurysms is associated with histopathological changes and linear reduction of aneurysm size over time. The results suggest that GKRS may be a viable, minimally invasive treatment option for intracranial aneurysm obliteration.

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Section: Discussionmentioning

confidence: 99%

Gamma Knife radiosurgery of saccular aneurysms in a rabbit model

Meadowcroft¹,

Cooper

Rupprecht³

et al. 2018

Journal of Neurosurgery

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Emerging roles of system antiporter and its inhibition in CNS disorders

Patel¹,

Kharkar

Nandave³

2015

Molecular Membrane Biology

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System [Formula: see text] is an antiporter belonging to the hetero(di)meric amino acid transporter family. It is located on astrocytes as well as on blood-brain barrier within the CNS. It plays a pivotal role in free radical neutralization as well as neuronal signalling by regulating the glutathione production which occurs via the exchange of intracellular glutamate with extracellular cystine at 1:1 molar ratio. Understandably, it is a vital component responsible for the maintenance of neuronal homeostasis (e.g. redox state). Hence, it could be postulated that any perturbation in system [Formula: see text] function may contribute, directly or indirectly, to the pathophysiology of a variety of CNS disorders like Alzheimer's disease, schizophrenia, drug addiction, depression, multiple sclerosis, hypoglycemic neuronal cell death, glioma, and excitotoxicity, making system [Formula: see text] a promising target for treating CNS disorders. In recent times, recognizing the potential of this target, variety of inhibitors has been synthesized by modifying commercially available potent inhibitors including sulfasalazine, erastin, and sorafenib. Although, they have demonstrated efficacy, the in-depth data is still lacking to warrant their use for the treatment of aforementioned CNS disorders. In this review, we discuss the in-depth role of system [Formula: see text] transporter in maintaining normal physiology as well as in the pathophysiology of CNS diseases. Additionally, we have also listed some of the potent inhibitors of system [Formula: see text]. In conclusion, the critical role of system [Formula: see text] in multiple CNS disorders and advanced research on its inhibitors have promising future prospects for better management of the CNS ailments.

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LINAC Stereotactic Radiosurgery for brain arteriovenous malformation: a single institutional experience from Saudi Arabia

Cited by 2 publications

References 14 publications

Gamma Knife radiosurgery of saccular aneurysms in a rabbit model

Gamma Knife radiosurgery of saccular aneurysms in a rabbit model

Emerging roles of system antiporter and its inhibition in CNS disorders

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