Effect of gammaknife radiosurgery on memory in patients with intracranial arteriovenous malformations- A prospective study

Narayanam Anantha Sai Kiran; Shashank Sharad Kale; Gundlakunta Swathi; Sandeep Vaishya

doi:10.5455/nmj/00000209

Abstract
Object: Memory impairment pre and post radiosurgery for intra cranial AVMs has been reported but the type of changes remain variable. The goal of this study is to determine the effect of gammaknife radiosurgery ( GKS) on memory in patients with intracranial AVMs.
Materials and Methods: The prospective study included all the patients of age more than 15 years with intracranial AVMs who received GKS during the two year study period from August 2003 to July 2005 in whom memory assessment was done prior to GKS and atleast at 6 months after GKS. Memory assessment was done using Memory Scale of AIIMS Comprehensive Neuropsychological Battery. Memory assessment pre GKS and at 6 months after GKS could be done in 35 patients. Memory assessment both at 6 months and 1 yr after GKS could be done in 27 patients.
Results: Abnormal memory scores were recorded in 4 patients pre GKS, 7 patients at 6 mths after GKS and in 4 patients at 1yr after GKS. Statistically significant impairment of memory pre GKS was observed in patients who underwent prior surgical evacuation of the intracerbral hematoma. Statistically significant impairment of memory at 1 yr after GKS was observed in patients with AVM of Spetzler Martin grade 3. Abnormal memory scores were more frequently recorded (statistically insignificant) in patients with temporal AVMs and in patients with large volume AVMs.
Conclusions: Patients with AVMs of higher Spetzler Martin grade, AVMs in temporal region and large volume AVMs constitute the high risk group for development of post gamma knife radiosurgery memory deficits.

Key words: arteriovenous malformation, cognitive deficits, gamma knife, memory, radiosurgery complications

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