Manipal Hospital Baner Treats Relapsed Brain AVM in Eloquent Region with Its First Single Session Stereotactic Radiosurgery

Pune: A 24-year-old patient diagnosed with a relapsed Arteriovenous Malformation (AVM) in an eloquent area of the brain was treated at Manipal Hospital, Baner, Pune, using single-session Stereotactic Radiosurgery (SRS).

The condition had previously been treated with GammaKnife in 2021 but had recurred, posing significant risks due to its location in a region responsible for critical neurological functions.

AVM is a condition characterized by an abnormal communication between arteries and veins through fragile and immature vessels. This vascular disorder can occur in any part of the body, including the brain.

While some individuals may remain asymptomatic, AVMs can cause tissue damage and bleeding, which may be fatal or result in permanent complications such as paralysis. Treatment approaches typically include surgical removal, embolization, or radiation-based reduction.

In this case, traditional neurosurgery was considered high-risk due to the lesion's location in a highly sensitive area of the brain. Stereotactic Radiosurgery was chosen as a non-invasive alternative to target the AVM with high precision.

Dr Karan Chanchlani, Consultant – Radiation Oncology, Manipal Hospital, Baner, Pune, said, "The complete dose was delivered in a single session with sub-millimeter accuracy. Meticulous planning was important since the patient had undergone GammaKnife therapy earlier without success. This was a technically challenging case since the AVM was located in a part of the brain that was very susceptible to neurological impairments after surgery."

"To precisely locate the nidus and determine the causes of the prior failure, we performed comprehensive MR with TOF sequences and Digital Subtraction Angiography considering the patient's history of recurrence after Gamma Knife radiosurgery. The patient underwent treatment with high-precision Stereotactic Radiosurgery (SRS), which delivered focused high dose of radiation with sub-millimeter accuracy in a short time. Most importantly, the entire procedure was non-invasive as we use Frameless systems for delivering our SRS plans. The post-procedure period was uncomplicated, and the patient is now stable, ambulatory, and recovering well," he further added.

Mr Anand Mote, Hospital Director, Manipal Hospital, Baner, Pune, said, "We are proud to bring cutting-edge radiosurgical capabilities to our center, especially for cases where traditional approaches are limited. At Manipal Hospital Baner, providing safe, accurate, and efficient care is our top priority. Our dedication to patient-centered innovation, teamwork, and medical quality is demonstrated by the successful resolution of this AVM case."

The patient is reported to be stable and recovering following the non-invasive procedure.