Radiotherapy of spontaneous carotid-cavernous sinus fistulas

Yasunaga, Tadamasa; Takada, Chitose; Uozumi, Hideaki; Saito, Yoko; Ueno, Shikiko; Hatanaka, Yoshimi; Baba, Yuji; Takahashi, Manabu

doi:10.1016/0360-3016(87)90359-2

Cited by 12 publications

(2 citation statements)

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“…Resolution of flow-related symptoms such as tinnitus or headache forms the basis of outcome assessment. [11][12][13] This methodology, however, is imperfect because the presence or absence of flow-related symptoms does not necessarily correlate with the risk of hemorrhage imposed by the malformation. 1,14,15 A useful method of assessing the efficacy of radiosurgical treatment should include both an evaluation of the anatomy of the nidus as documented by angiography and clinical follow-up to identify the rate of neurological deficits resulting from either radiation effects or intracranial hemorrhage.…”

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Gamma Knife Radiosurgery for Dural Arteriovenous Fistulas

et al. 2010

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Gamma Knife Radiosurgery for Dural Arteriovenous Fistulas

et al. 2010

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“…There are other reports on the use o f radiosurgery [10,11] and of fractionated irradia tion alone [12][13][14], or in combination with intravascular embolization [15] to C C F , achieving the beginning o f an improvement as early as 15 days after irradia tion, and an 83.3% closure rate between 1 month and 4 years. The relative safety and efficacy of this technique makes it the treatment o f choice for low-flow C C F , while intravascular embolization maintains its indications for the high-flow ones.…”

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Stereotactic Radiosurgery for the Treatment of Low-Flow Carotid-Cavernous Fistulae: Results in a Series of 25 Cases

Barcia-Salorio

Soler

Barcia

et al. 1994

Stereotact Funct Neurosurg

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25 patients with low-flow carotid-cavernous fistula (CCF) underwent radiosurgery between 1977 and 1992. 22 had spontaneous low flow fistulae and 3 traumatic high flow fistulae which had been previously treated with internal carotid trapping. The mean preoperative symptomatic period was 12.2 months (4–24 months). Fistulae were classified according to Barrow''s classification. Type T was added for traumatic, high-flow fistulae with flow reduction after internal carotid trapping. 11 cases were of type B, 4 of type C, 7 of type D and 3 of type T. The target point for radiosurgry was calculated from selective internal or external carotid angiograms. Stereotaffi;lradiosurgery was performed with a cobalt source, with 5- to 10-mm collimators. A total dose of 30–40 Gy was delivered in all cases, except 1 posttraumatic case in which the dose was 20 Gy. The follow-up period ranged between 14 years and 15 months (mean: 49.76 months). 20 of the 22 low flow fistulae (90.9%) completely closed in a mean period of 7.5 months (range: 2–20 months) after radiosurgery. Improvement of the symptoms began at a mean period of 2.37 months (range: 0.5–14 months). There were no recurrences, the follow-up period ranging between 14 years and 15 months. 100% of type B CCF closed after a mean period of 5.9 months, 75% of type C closed after a mean period of 12.66 months, and 85.7% of cases of type D closed after a mean period of 8.16 months. Only one of the three traumatic fistulae (type T) was cured 6 months after radiosurgery, while there was no significant change in the other two cases of type T fistulae. There was no untoward effect attributable to irradiation in the whole series. The authors conclude that because of its relative safety and efficacy this technique makes it the treatment of choice for low-flow CCF, while intravascular embolization maintains its indications for the high-flow ones.

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Benndorf

2010

Medical Radiology

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Radiotherapy of spontaneous carotid-cavernous sinus fistulas

Cited by 12 publications

References 7 publications

Gamma Knife Radiosurgery for Dural Arteriovenous Fistulas

Gamma Knife Radiosurgery for Dural Arteriovenous Fistulas

Stereotactic Radiosurgery for the Treatment of Low-Flow Carotid-Cavernous Fistulae: Results in a Series of 25 Cases

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