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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1990 Jun;53(6):476–479. doi: 10.1136/jnnp.53.6.476

Cerebral radiation necrosis complicating stereotactic radiosurgery for arteriovenous malformation.

P Statham 1, P Macpherson 1, R Johnston 1, D M Forster 1, J H Adams 1, N V Todd 1
PMCID: PMC1014206  PMID: 2199611

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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