Follow-up/Surveillance

Question 1

What are the reported rates of permanent weakness or paralysis, aphasia, and hemianopsia for grades I–III AVM pts treated with Sg?

Answer 1

The rate of serious postsurgical complications is 0%–15%.

Question 2

What are the common early and delayed complications after SRS for AVMs?

Answer 2

Overall, there is about an 8% risk of RT-related complications.

Early: seizures (up to 10%), n/v, HA

Delayed: seizures, hemorrhage, radionecrosis (1%–3% risk), new neurologic deficits, edema, venous congestion, cyst formation

Question 3

What is the incidence of transient vs. permanent neurologic complications after SRS for AVMs?

Answer 3

Complications after SRS for AVMs are as follows: transient (5%) vs. permanent (1.4%).

Question 4

On what 2 factors do complication rates after SRS for AVMs primarily depend?

Answer 4

Size of AVM and RT dose

Question 5

What does the f/u entail after Tx for AVMs?

Answer 5

Adequate f/u includes routine H&P + MRI q6 mos for 1–3 yrs, then annually.

Question 6

What study needs to be performed once the MRI shows evidence of AVM obliteration?

Answer 6

An angiogram needs to be performed (in addition to MRI) to confirm complete AVM obliteration.