Safety and efficacy of preoperative embolization in the treatment of brain arteriovenous malformations with perinidal aneurysms and single draining vein: a multicenter study with propensity score-weighting.

Background And Objectives: Arteriovenous malformations (AVMs) with perinidal aneurysms and single draining vein are associated with an elevated risk of rupture and increased procedural complexity. The role of preoperative embolization in this high-risk anatomical subset remains unclear. This study aimed to evaluate the safety and efficacy of microsurgery with preoperative embolization, compared with microsurgery alone in patients with such AVMs.

Comparison of stereotactic radiosurgery and rhizotomy for trigeminal neuralgia: A systematic review and Meta-Analysis.

Objective: Trigeminal neuralgia (TN) is a chronic, debilitating neuropathy characterized by sudden, severe facial pain, often refractory to medical therapy. When medications fail, surgical options such as microvascular decompression (MVD) are preferred, but for patients unsuitable for open surgery, stereotactic radiosurgery (SRS) and percutaneous rhizotomy are viable alternatives. This systematic review and meta-analysis aimed to compare the efficacy and safety of SRS and rhizotomy in the management of TN.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Role of Radiosurgery for Patients With Functioning Pituitary Adenomas.

Background: Patients with functioning pituitary adenomas (FPA) require a multidisciplinary team-based approach to select best medical, surgical, and radiation treatments, including stereotactic radiosurgery (SRS).

Objective: The aim of this study was to provide evidence-based recommendations on the use of SRS for adult patients with FPA.

Methods: PubMed and Embase were searched from data base inception to June 8, 2021.

Outcome Evaluation of Volume-Staged Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations.

Background And Objectives: Single-session stereotactic radiosurgery (SRS) has limited role for large arteriovenous malformations (AVM). Volume-staged SRS (VS-SRS) is used to optimize outcomes, but studies reporting results are limited.

Methods: This multicenter retrospective cohort of 378 patients from 21 centers reports results of VS-SRS for the entire AVM nidus.

Laser interstitial thermal therapy for high-grade glioma: a systematic review, meta-analysis, and meta-regression.

Objective: Despite advances in the management of high-grade glioma (HGG), overall survival (OS) and progressionfree survival (PFS) remain suboptimal given the aggressive nature of these tumors. Difficult-to-access tumor locations, high complication rates, and high tumor progression rates further complicate the treatment of HGG. Herein, the authors aimed to comprehensively evaluate the safety and efficacy of laser interstitial thermal therapy (LITT) for HGG.

Stereotactic radiosurgery and fractionated radiation therapy in the management of pituitary tumors.

Pituitary tumors require a diverse, multidisciplinary approach in their management. Stereotactic radiosurgery (single or hypofractionated) and fractionated radiotherapy are integral parts of the armamentarium. With the introduction of highly conformal, stereotactic ionizing radiation approaches, the reported tumor control rates and clinical outcomes have improved significantly.

Further points to consider regarding the resection strategy of eloquent brain metastasis in the era of postoperative stereotactic radiotherapy.

Häni et al. present an important analysis evaluating outcomes following resection of eloquent brain metastases without surgical margins in the context of postoperative stereotactic radiotherapy. While their findings support functional preservation without compromising local control, we believe several clinical nuances warrant further discussion.

Radiation-induced cerebral cavernous malformation following stereotactic radiosurgery for a brain metastasis.

Radiation-induced cerebral cavernous malformations (RICMs) are rare complications of stereotactic radiosurgery (SRS). We present a woman in her 70s who underwent Gamma Knife radiosurgery for breast cancer brain metastases. She subsequently developed a haemorrhagic lesion in the left parietal lobe, confirmed as RICM by histopathological examination.

Multicenter Retrospective Study of Stereotactic Radiosurgery for Gynecological Cancer Brain Metastases.

Background And Objectives: Gynecological cancers represent 10% to 15% of cancers in women, but brain metastases (BM) are uncommon, with limited evidence regarding their management. This study investigates the role of stereotactic radiosurgery (SRS) for BM from primary gynecological cancers.

Methods: Institutions of the International Radiosurgery Research Foundation participated in this study.

Melatonin Ameliorate neuroinflammation in activated microglia through the Aryl hydrocarbon-Nrf2 axis.

Microglia-mediated neuroinflammation is central to many neurological disorders. The Aryl hydrocarbon receptor (AhR) is highly expressed in microglia and plays a key role in neuroinflammation. While melatonin has anti-inflammatory effects in neurodegenerative disorders, its connection to AhR in modulating neuroinflammation is unclear.

Impact of smoking on occlusion rates following stereotactic radiosurgery for Spetzler Martin grade I-III brain arteriovenous malformations - A propensity score matched analysis of the MISTA consortium.

Backgroundand Objective: The authors compareocclusion rates in grade I-III AVMs in smokers and non-smokers, using propensity score matching (PSM).

Methods: The authors performed a subgroup analysis of the MISTA consortium, a multicenter registry that includes patients aged 1 to 89 years with AVMs treated between January 2010 and December 2023. Only grade I-III AVMs were included.

Predictors of treatment response and overall survival in patients with breast cancer brain metastases treated with stereotactic radiosurgery: a prospective study using the NeuroPoint Alliance SRS Registry.

Objective: The aim of this study was to evaluate mortality and progression outcomes in patients undergoing stereotactic radiosurgery (SRS) for breast cancer brain metastases and to identify associated risk factors using a national quality registry.

Methods: The NeuroPoint Alliance (NPA) SRS Registry was employed for this study, which conducted prospective enrollment of patients undergoing SRS at 16 participating centers from 2017 to 2024. Outcomes of interest included the post-SRS EQ-5D score change, overall survival, local progression, out-of-field progression, and overall intracranial progression.

Clinical outcomes following stereotactic radiosurgery for brain metastases from sarcoma primaries: An international multicenter analysis.

Background: There is a paucity of data on treatment outcomes following stereotactic radiosurgery (SRS) for brain metastases from sarcoma primaries.

Methods: The International Radiosurgery Research Foundation member-sites were queried for patients with brain metastases from sarcoma primaries treated with SRS. Overall survival (OS) and local control (LC) were calculated via Kaplan-Meier analysis.

Outcomes After Stereotactic Radiosurgery for Intracranial Hemangioblastoma in Von Hippel-Lindau Disease and Sporadic Cases: An International Multicenter Study.

Background And Objectives: Hemangioblastomas (HGBs) are rare, benign, World Health Organization grade 1 vascular tumors, which are most commonly located in the cerebellum, and may occur sporadically or in association with von Hippel-Lindau (VHL) disease, a hereditary VHL-mutated tumor syndrome. Limited data are available regarding factors affecting outcomes after stereotactic radiosurgery (SRS). We aim to provide a contemporary evaluation of SRS for HGBs through an international, multicenter study.

Stereotactic radiosurgery for brain metastases.

Brain metastases are the most common intracranial malignancies in adults, and, depending on primary tumor type, they may affect up to 50 % of cancer patients. Although advances in systemic and local therapies have led to improvements in patient overall survival and progression free survival, there remains substantial opportunities to improve patient outcomes. Stereotactic radiosurgery (SRS) delivers high doses of ionizing radiation with sub-millimeter accuracy to discrete intracranial tumors.

Stereotactic radiosurgery versus observation for intracranial low-grade dural arteriovenous fistulas.

Background: Given the low haemorrhagic risk of intracranial low-grade dural arteriovenous fistulas (dAVFs), the benefits of routine intervention remain controversial. This study compares patient outcomes treated with stereotactic radiosurgery (SRS) versus conservative management.

Method: Multicentre retrospective analysis of the Consortium for Dural Arteriovenous Fistula Outcomes Research and the International Radiosurgery Research Foundation data.

Outcomes of stereotactic radiosurgery for pituitary metastases: an international multi-institutional study.

Background: Pituitary metastases (PM) account for 0.4% of all intracranial metastases and typically present with visual and endocrinological deficits. Stereotactic radiosurgery (SRS) has shown excellent tumor control and safety profile in the management of intracranial metastases.

Revisiting radioresistance: a systematic review of outcomes of Stereotactic radiosurgery (SRS) in functional head and neck paragangliomas.

This systematic review evaluates the role of stereotactic radiosurgery (SRS) in managing functional head and neck paragangliomas (FPG), which pose unique challenges due to catecholamine secretion and associated functional symptoms. Currently there are no established management guidelines for FPG because of their rarity. We explore clinical, radiological and hormonal outcomes of SRS and conventional radiotherapy (RT), challenging traditional assumptions of radioresistance in FPG.

Outcomes of gamma knife treated large symptomatic arteriovenous malformations according to guidelines of Taiwan neurosurgical consensus.

Background: The treatment of large arteriovenous malformations (AVMs), in particular those unruptured, remains a topic of debate. Stereotactic radiosurgery has favorable outcomes for small to medium-sized AVMs. However, for large AVMs, the goal is to maximize obliteration rates and at the same time, to minimize radiation-induced complications.

ACR Appropriateness Criteria® Brain Tumors.

Brain tumors represent a complex and clinically diverse disease group, whose management is particularly dependent on neuroimaging given the wide range of differential diagnostic considerations and clinical scenarios. The introduction of advanced brain imaging tools into clinical practice makes it paramount for all treating physicians to recognize the range and understand the appropriate application of various conventional and advanced imaging modalities. The imaging recommendations for neuro-oncologic clinical scenarios involving screening in patients with increased genetic risk, screening in patients with systemic malignancy, pretreatment evaluation in patients with intra- and extraaxial brain tumors, posttreatment-surveillance in patients with known brain tumors after completion of therapy, and subsequent workup in the context of suspected radiographic progression are encompassed by this document.

Radiosurgery for central nervous system ependymomas: a systematic review and meta-analysis.

Background: Ependymomas, rare malignant central nervous system (CNS) lesions (2-6% of primary CNS tumors), are typically treated with maximal safe resection followed by fractionated radiation therapy. Stereotactic radiosurgery (SRS) has emerged as an alternative, particularly in recurrent or residual cases. This study evaluates the safety and efficacy of SRS for CNS ependymomas, while also identifying key prognostic factors.

Focused ultrasound-microbubble treatment arrests the growth and formation of cerebral cavernous malformations.

Cerebral cavernous malformations (CCMs) are vascular lesions within the central nervous system that cause debilitating neurological symptoms. Currently, surgical excision and stereotactic radiosurgery, the primary treatment options, pose risks to some patients. Here we tested whether pulsed, low intensity, focused ultrasound-microbubble (FUS-MB) treatments control CCM growth and formation in a clinically representative Krit1 null murine model.

Outcomes of arteriovenous malformations with single versus multiple draining veins: A multicenter study.

Background: Cerebral arteriovenous malformations (AVMs) are complex vascular lesions that pose a risk for hemorrhagic stroke. The number of draining veins has recently emerged as a significant predictor of rupture risk. This multicenter study aimed to evaluate the outcomes in adult AVM patients with single versus multiple draining veins.

International multicenter study of stereotactic radiosurgery for bladder cancer brain metastases.

Purpose: Bladder cancer rarely metastasizes to the brain. This study was performed to evaluate stereotactic radiosurgery (SRS) for the management of bladder cancer brain metastases.

Methods: Cases of bladder cancer brain metastases treated with SRS were collected by members of the International Radiosurgery Research Foundation (IRRF) and outcome data was analyzed for patients with at least one clinical or imaging follow-up.

Large vestibular schwannoma treated using a cranial nerve sparing approach with planned subtotal microsurgical resection and stereotactic radiosurgery: meta-analysis and International Stereotactic Radiosurgery Society (ISRS) practice guidelines.

Introduction: Stereotactic radiosurgery (SRS) has become a standard of care for small- to medium- size vestibular schwannomas (VS), while the majority of patients with large VS still require microsurgical resection due to potential consequences of long tract and cranial nerve compression, intracranial hypertension or hydrocephalus.

Methods: We performed a systematic review and meta-analysis of the literature specific to planned subtotal resection for large VSs followed by SRS to the residual tumor to inform clinical practice guideline development. The Medline and Embase databases were used to apply the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) approach to search for manuscripts reporting outcomes for large VSs treated with this paradigm, with a search end date of June 1st 2023.