Craniotomy or Cyber/GammaKnife

Hi all, I’m new to this forum and have a small (1cm) fast flowing AVM in the front left of my brain in a fairly unimportant part of my brain (according to doctors:-)
I am left with a choice between craniotomy (of the most straightforward kind - according to the neurosurgeon) or cyber/gamma knife. Everythng seems about equal and I wanted to know if any of you had this choice.
Which decision did you make, any regrets?

Hi again

I should have added: I’m completely asymptomatic as the AVM was discovered purely by chance after an unrelated procedure.

The surgeons I saw wanted me to have a craniotomy (which is what I did–mine are some of those traumatic pictures Liam mentioned). They didn’t really present gamma knife as an option, I think because I had had multiple bleeds and the craniotomy was guaranteed to produce immediate results. My AVM was also in a supposedly unimportant part of the brain and one that was very easy to access with very low risk of stroke. Given the chance to do it over again, I would still choose the craniotomy; the surgery was actually far less traumatic than the hemorrhage I had a few months back, and worrying about another hemorrhage was slowly eroding my sanity. However, since you aren’t symptomatic, cyber knife might be an easier route. Invasive surgery is always scary, and I’m not sure how old you are (the older you are, the longer your recovery time would probably be). I see you’re from California–where are you thinking about being treated? I went to Stanford, but another woman on this site had a great experience at UCLA.

Both have their trade-offs. Here’s a good article to get started with: http://www.brainandspine.org.uk/information/publications/brain_and_…

My own personal experience? So many variables, but ultimately it was this - I had already put my family through a near-fatal brain hemorrhage so I decided I would rather put myself through the anxiety of waiting 2 years for obliteration through gamma-knife than put them through an invasive crainiotomy. No regrets, AVM almost gone 12 months later with very minimal side effects.

Just noticed there is another Pauline on the network, I have changed my name to Pauline B to distinguish. Funnily enough I’m originally from Glasgow - same place as the other Pauline!!

At least you have different profile pictures. :slight_smile:

I had the gamma knife done after it bleed and was completely satisfied!

– Shana

There is still the possibility with a craniotomy that they do not get all of it, it is not necessarily a definitive cure…I also agree with what everyone else said.

Hi all

Well I decided on the cyberknife and had my treatment last Wednesday. I join some of you waiting to see how successful the treatment will be and hope that side-effects are minimal.
Pauline B

I’m really interested in the decision you’re facing because mine’s exactly the same… left front with the same options presented. I haven’t come to my decision yet which is why I’m here! Surgery is a more ‘sure’ route, but leaves scars and is more invasive. Gamma knife isn’t as sure of a thing, but relatively painless and quicker (as I understand). I’ve also recently found information on a new minimally invasive surgery where they go in through the sinuses and remove through the nose and am posting here trying to get more info on it too.
On a side note, my doctors have told me the same thing about ‘you’re lucky it’s on an unimportant part of your brain.’ So, if that part of the brain is unimportant, why is it there? I think there’s more too that part of the brain than has been figured out yet.

Congrats on getting the procedure done, Pauline! How are you feeling?

Hi Beth

Yes I’m sure that left frontal lobe will turn out to be most significant one day :slight_smile: It was a difficult decision but I just couldn’t face “brain surgery” when I have never had any symptoms. Maybe if I had had a bleed or some other problem associated with the AVM, I might have thought differently. My Dad had an aneurism and resulting brain surgery and I just couldn’t bring myself to believe that recovery would be straightforward. Even one month of tiredness seemed unthinkable. Interestingly, when I went for the cyberknife treatment the doctor was insistent that my AVM was a great candidate for cyberknife. Good luck with the decision, it really boils down to your own individual circumstance and how you feel about the options. I’m still not sure mine was the right decision but it was my best given my 3 kids, my job, my life.

Hi Connie
Thanks. I feel normal, ordinary, just like usual. Isn’t that great. I know I have a long way to go but feeling like myself is a good start. Hope you are well and I promise to get a photo onboard when I find one :slight_smile: