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Or Cohen-Inbar, Robert M. Starke, Gabriella Paisan, Hideyuki Kano, Paul P. Huang, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, David Mathieu, Danilo Silva, Mahmoud Abbassy, Symeon Missios, John Y. K. Lee, Gene H. Barnett, Douglas Kondziolka, L. Dade Lunsford and Jason P. Sheehan

between groups when symptomatic or permanent RICs were compared (9.9% late vs 7.5% early responders, p = 0.468 for symptomatic RICs; and 2.3% vs 3%, respectively, p = 0.431 for permanent RICs). Overall mortality rates were comparable between the 2 groups (2.2% late vs 3% early responders, p = 0.886). Favorable outcome (that is, AVM nidus obliteration without post-SRS latent phase hemorrhage or permanent SRS-associated RICs) was not found to differ significantly between the 2 groups (p = 0.421). As shown in Table 2 , patients who received a higher margin dose were more

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Dale Ding, Robert M. Starke, Hideyuki Kano, David Mathieu, Paul P. Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

followed for 9 years found a 13 per 100,000 annual incidence of stroke, including 8 per 100,000 and 5 per 100,000 annual incidences of ischemic and hemorrhagic stroke, respectively. 36 In 82% of the patients who suffered a hemorrhagic stroke, the cause was a vascular malformation. 36 A study including 116 children with hemorrhagic stroke found an AVM to be the cause in 31% of cases. 41 In a cohort of 34 patients with spontaneous ICH, an AVM was identified as the cause in 47%. 50 The ICH mortality rate was 25%, and 22% of survivors suffered from severe neurological

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Robert M. Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P. Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

patients died (0.8%), resulting in a combined neurological morbidity and mortality rate of 5.3%. The rates of increased seizure frequency and de novo seizures were 6.9% (2/29 patients) and 0.3% (1/328 patients), respectively. Favorable Outcome At last follow-up, a favorable outcome (defined as AVM obliteration, no post-radiosurgery hemorrhage, and no permanently symptomatic RIC) was achieved in 211 patients (59.1%; Fig. 4 ). Table 4 details the univariate and multivariate logistic regression analyses for predictors of favorable outcome after radiosurgery. In the

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Dale Ding, Robert M. Starke, Hideyuki Kano, John Y. K. Lee, David Mathieu, John Pierce, Paul P. Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

commonly used system for stratifying AVMs, and its grade is derived from the nidus size, anatomical brain location, and venous drainage pattern of the AVM. 59 The SM grading system has been found to correlate with postoperative neurological morbidity and mortality rates after surgery at AVM centers with experienced personnel, and it is also correlated with outcomes after radiosurgery. 24–26 , 34 , 39 , 42 Spetzler-Martin Grade III AVMs represent the border zone between SM Grades I and II AVMs, which are typically managed with an early intervention, and SM Grades IV

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Radek Kolecki, Vikalpa Dammavalam, Abdullah Bin Zahid, Molly Hubbard, Osamah Choudhry, Marleen Reyes, ByoungJun Han, Tom Wang, Paraskevi Vivian Papas, Aylin Adem, Emily North, David T. Gilbertson, Douglas Kondziolka, Jason H. Huang, Paul P. Huang and Uzma Samadani

randomized to either an ICP-monitored group or medical management. In this study investigators were unable to detect any significant improvement in outcome in monitored patients treated for ICP > 20 mm Hg compared with patients who were not monitored and only treated clinically. Other studies have demonstrated lower mortality rates in trauma patients undergoing ICP monitoring. 24 , 34 This raises the possibility that the threshold of 20 mm Hg defining elevated ICP may be inappropriately high, or that there may be other factors such as tissue compliance that also impact

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Mohana Rao Patibandla, Dale Ding, Hideyuki Kano, Zhiyuan Xu, John Y. K. Lee, David Mathieu, Jamie Whitesell, John T. Pierce, Paul P. Huang, Douglas Kondziolka, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

significant in the univariate analysis (p < 0.05). Permanent neurological morbidity occurred in 27 patients (11.6%), and 12 patients died after SRS (5.2%), yielding a combined permanent morbidity and mortality rate of 16.8%. Favorable Outcome Favorable outcome (i.e., AVM obliteration, no post-SRS hemorrhage, and no permanent RIC) was achieved in 61 patients (26.2%). Table 5 details the univariate and multivariate logistic regression analyses for predictors of unfavorable outcome after SRS. Larger AVM maximum diameter (p = 0.002) and prior AVM hemorrhage (p = 0.044) were