Volume-Staged CyberKnife Stereotactic Radiosurgery for Treatment of Drug-Resistant Epilepsy for a Spetzler-Martin Grade V Arteriovenous Malformation: A Case Report and Review of the Literature.

BACKGROUND: Evidence to support the use of stereotactic radiosurgery (SRS) in the treatment of epilepsy secondary to cerebral arteriovenous malformations (AVMs) is emerging. However, these studies have not clearly demonstrated the use of SRS in the treatment of drug-resistant epilepsy (DRE) in high Spetzler-Martin grade (IV-V) AVMs. CASE DESCRIPTION: We present a 48-year-old woman with DRE secondary to a Spetzler-Martin grade V cerebral AVM. She was treated with volume-staged SRS (VS-SRS) and achieved near-complete resolution of her seizures with incomplete obliteration of the AVM. Six years after treatment, she has experienced no serious complications. CONCLUSIONS: VS-SRS successfully controlled seizures (Engel Outcome Measure of 1A) in a patient with intractable, DRE secondary to a high-grade cerebral AVM.