Cerebral radiation necrosis complicating stereotactic radiosurgery for arteriovenous malformation. Issue 6 (June 1990)

• Record Type: Journal Article
• Authors: Statham, P; Macpherson, P; Johnston, R; Forster, D M; Adams, J H; Todd, N V
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 53:Issue 6(1990)
• Page Start: 476
• Page End: 479
• Publication Date: 1990-06
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.53.6.476
• Languages: English
• ISSNs: 0022-3050

Abstract

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.