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Acta Neurochirurgica

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01-05-2010 | Case Report

Operative intervention for delayed symptomatic radionecrotic masses developing following stereotactic radiosurgery for cerebral arteriovenous malformations—case analysis and literature review

Authors: Mansoor Foroughi, Andras A. Kemeny, Martin Lehecka, Juliana Wons, Lisa Kajdi, Richard Hatfield, Sidney Marks

Published in: Acta Neurochirurgica | Issue 5/2010

Abstract

Case report

We report two cases of operative intervention that was beneficial in the treatment of delayed symptomatic radionecrotic masses that had developed following stereotactic radiosurgery (SRS) using the gamma knife (GK) for the treatment of cerebral arteriovenous malformations (AVM).

Discussion

Case 1 involved a small craniotomy for decompression of a large cerebral multiloculated cyst, which had become symptomatic 84 months following gamma knife treatment for a left frontal lobe AVM. Case 2 involved surgical excision of an occipital radionecrotic mass 72 months following GK treatment for an occipital AVM. This patient had suffered from longstanding symptomatic cerebral oedema, which on occasions had become life threatening. Case 2 is also the first report of a radionecrotic mass occurring post-SRS for an AVM, which conversely appeared to demonstrate increased uptake on single photon emission computed tomography (SPECT) scan. The first literature review of such delayed symptomatic radionecrotic lesions is presented. There appears to be a late onset of symptoms (average 55 months, range 12–111 months) associated with such radionecrosis. Drainage of such cysts or excision of the mass lesion appears to be consistently beneficial to the patients and appears to be uncomplicated.

Conclusion

We recommend early surgical intervention for such delayed symptomatic radionecrotic masses that do not resolve following non-operative management. We also recommend caution in interpretation of SPECT scan results when attempting to differentiate radionecrosis from neoplasia.

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Title: Operative intervention for delayed symptomatic radionecrotic masses developing following stereotactic radiosurgery for cerebral arteriovenous malformations—case analysis and literature review
Authors: Mansoor Foroughi
Andras A. Kemeny
Martin Lehecka
Juliana Wons
Lisa Kajdi
Richard Hatfield
Sidney Marks
Publication date: 01-05-2010
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 5/2010
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-009-0581-1

2024 ASCO Annual Meeting

Springer Medicine

Operative intervention for delayed symptomatic radionecrotic masses developing following stereotactic radiosurgery for cerebral arteriovenous malformations—case analysis and literature review

Abstract

Case report

Discussion

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Case report

Discussion

Conclusion

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