ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Long-term outcomes and safety of Gamma Knife radiosurgery in pediatric arteriovenous malformations.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDespite the unique challenges presented by pediatric intracranial AVMs, little data is available on the use of GKRS in the pediatric population. Therefore, we aimed to present our experience with GKRS in treating pediatric AVMs, determining the factors that influence nidus obliteration and poor outcomes, with a focus on delayed complications.
methodsThis retrospective review examined patients ≤18 years who underwent GKRS between January 2013 and December 2021 for intracranial AVMs. Factors that predicted residual nidus and poor outcomes were analyzed. The utility of AVM size reduction at follow-up in predicting eventual nidus obliteration was tested.
resultsWe treated 101 pediatric patients for AVMs with a mean age of 14.2 ± 2.8 years. The mean dose delivered was 22.7 ± 2.4 Gy. After a mean follow-up of 41.4 months, 78 AVMs (77.8%) were obliterated. Residual nidus was associated with prior embolization (HR 4.953; 95% CI 1.343, 18.268; p = 0.016) and age ≥14 years (HR 5.920; 95% CI 1.559, 22.480; p = 0.009) while presentation with bleed (HR 0.178; 95% CI 0.05, 0.631; p = 0.008) was protective. Reduction in size of a nidus during early follow-up closely correlated with eventual obliteration, with increasing accuracy at 6-month, 12-month, and 24-month follow-up (67.6%, 80.2%, and 86.5% respectively). Twelve patients developed perilesional edema, while one patient each developed a chronic encapsulated hematoma (CEH), cyst formation, and rebleed. Dose > 22 Gy (HR 25.641; 95% CI 2.257, 250; p = 0.009) and volume ≥ 3 cc (HR 7.189; 95% CI 1.176, 43.945; p = 0.033) predicted poor outcomes on multivariate analysis.
conclusionsGKRS delivers a high rate of AVM nidus obliteration in the pediatric population, with prior embolization, older age, and unruptured presentation associated with residual nidus. The incidence of delayed complications, although low, warrants regular surveillance in the pediatric population due to their greater life expectancy.
Indexed as
Identifiers
40232520What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.