Radiosurgical treatment of a cerebral arteriovenous malformation in a patient with moyamoya disease: case report.

Abstract

A case of a cerebral arteriovenous malformation (AVM), which was treated with gamma knife surgery, in a patient with moyamoya disease is described. This is the first report of radiosurgical treatment of a cerebral AVM in a patient with moyamoya disease; the outcome was satisfactory. The patient presented with frequent episodes of transient ischemic attacks and seizures. Staged encephaloduroarteriosynangiosis was performed on both sides, with an interval of 10 months. Postoperative cerebral angiography demonstrated augmented cerebral perfusion, which increased the size of the AVM nidus. The patient subsequently underwent gamma knife surgery, and the AVM completely disappeared 2 years later. Radiosurgery may be a good treatment option for AVMs accompanying moyamoya disease, allowing the preservation of collateral vessels and the prevention of possible misery perfusion.