Cerebral Radiation Necrosis Complicating Stereotactic Radiosurgery for Arteriovenous Malformation

Overview

Journal J Neurol Neurosurg Psychiatry

Publisher BMJ Publishing Group

Specialties Neurology
Neurosurgery
Psychiatry

Date 1990 Jun 1

PMID 2199611

Citations 3

Authors

P Statham

P Macpherson

R Johnston

D M Forster

J H Adams

N V Todd

Affiliations

Soon will be listed here.

Abstract

A patient presented with symptoms and signs of raised intracranial pressure and increasing focal deficit 13 months after stereotactic radiosurgical treatment of an arteriovenous malformation (AVM). Computed Tomography (CT) showed a mass lesion at the site of the previous abnormality typical of radiation necrosis, but with features identical to those of a malignant neoplasm. Biopsy confirmed cerebral radiation necrosis. The radiation dose was 25 Gray to the periphery of two overlapping 14 mm collimator fields, delivered in a single dose. Treatment with steroids led to improvement in the symptoms and signs of raised intracranial pressure, but not the focal deficit. Radiation necrosis is a consequence of the large doses required to obliterate AVMs and is a limiting factor in their treatment. It is important for clinicians referring patients for stereotactic radiosurgery to be aware of this complication, and to be able to recognise and treat it.

Citing Articles

Efficacy of radiosurgery with and without angioembolization: A subgroup analysis of effectiveness in ruptured versus unruptured arteriovenous malformations - An updated systematic review and meta-analysis.

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Complications associated with immunotherapy for brain metastases.

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AVM resection after radiation therapy--clinico-morphological features and microsurgical results.

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Focal brain radiotherapy.

Plowman P J Neurol Neurosurg Psychiatry. 1990; 53(7):541.

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