Radiation-induced complication of stereotactic radiosurgical treatment of cavernous malformation of the brain
https://doi.org/10.17650/1683-3295-2024-26-4-88-93
Abstract
The aim of the work – to present a case of radiation-induced complication after radiosurgical stereotaxic treatment of cavernous malformation of the brain.
A patient, 34-year-old, applied to the Radiosurgery Center of the N. V. Sklifosovsky Research Institute for Emergency Medicine with complaints of frequent headaches, general weakness. The magnetic resonance imaging of the brain revealed a deep cavernous malformation in the left hemisphere of the brain. In order to reduce the risk of re-rupture of the cavernous malformation, it is recommended to perform a stereotaxic radiosurgical operation using the Elekta Leksell Gamma Knife Perfexion apparatus. The possibilities of treating cerebral cavernous malformations have significantly expanded with the use of stereotaxic radiosurgery. Radiosurgery is an alternative treatment for symptomatic cavernous malformations in cases of deep-seated lesions in functionally significant areas of the brain, the surgical removal of which is associated with a high risk of worsening neurological symptoms. However, complications after radiosurgical stereotaxic treatment are an urgent problem, and subsequent follow-up with a clinical assessment of the patientʼs condition and neuroimaging requires attention and a multidisciplinary approach.
Keywords
Supporting agencies: The work was performed without external funding
About the Authors
E. N. Girya
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
Elena Nikolaevna Girya
129090; 3 Bolshaya Sukharevskaya Sq.; Moscow
O. L. Evdokimova
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
129090; 3 Bolshaya Sukharevskaya Sq.; Moscow
A. A. Kochakova
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
129090; 3 Bolshaya Sukharevskaya Sq.; Moscow
A. S. Tokarev
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; Moscow Healthcare Department
Russian Federation
Russian Federation
129090; 3 Bolshaya Sukharevskaya Sq.; 127006; 43 Oruzheyniy Ln.; Moscow
V. E. Sinitsyn
Medical Scientific and Educational Center, Lomonosov Moscow State University
Russian Federation
Russian Federation
119192; Bld. 10, 27 Lomonosovsky Ave.; Moscow
References
1. Shen C.C., Sun M., Yang M.Y. et al. Outcome of intracerebral cavernoma treated by Gamma Knife radiosurgery based on a double-blind assessment of treatment indication. Radiat Oncol 2021;16(1):164. DOI: 10.1186/s13014-021-01885-4
2. Neuroradiosurgery on a gamma knife. Ed. by A.V. Golanov, V.V. Kostyuchenko. Moscow: IP T.A. Alekseeva, 2018. 958 p. (In Russ.).
3. Treatment of patients with cavernous malformations of the central nervous system. Clinical recommendations of the Association of Neurosurgeons of Russia. Moscow, 2014. (In Russ.). Available at: https://www.ruans.org/Text/Guidelines/cavernoma.pdf
4. Del Curling O. Jr., Kelly D.L. Jr, Elster A.D., Craven T.E. An analysis of the natural history of cavernous angiomas. J Neurosurg 1991;75(5):702–8. DOI: 10.3171/jns.1991.75.5.0702
5. Robinson J.R., Awad I.A., Little J.R. Natural history of the cavernous angioma. J Neurosurg 1991;75(5):709–14. DOI: 10.3171/jns.1991.75.5.0709
6. Attar A., Ugur H.C., Savas A. et al. Surgical treatment of intracranial cavernous angiomas. J Clin Neurosci 2001;8(3):235–9. DOI: 10.1054/jocn.2000.0787
7. Lee C.C., Wang W.H., Yang H.C. et al. Gamma Knife radiosurgery for cerebral cavernous malformation. Sci Rep 2019;9(1):19743. DOI: 10.1038/s41598-019-56119-1
8. Liu K.D., Chung W.Y., Wu H.M. et al. Gamma knife surgery for cavernous hemangiomas: an analysis of 125 patients. J Neurosurg 2005;102(Suppl):81–6. DOI: 10.3171/jns.2005.102.s_supplement.0081
9. Valk P.E., Dillon W.P. Radiation injury of the brain. AJNR Am J Neuroradiol 1991;12(1):45–62.
10. Liao C., Visocchi M., Zhang W. et al. Management of cerebral radiation necrosis: a retrospective study of 12 patients. Acta Neurochir Suppl 2017;124:195–201. DOI: 10.1007/978-3-319-39546-3_30
11. Nimjee S.M., Powers C.J., Bulsara K.R. Review of the literature on de novo formation of cavernous malformations of the central nervous system after radiation therapy. Neurosurg Focus 2006;21(1):e4. DOI: 10.3171/foc.2006.21.1.5
12. Aboukais R., Estrade L., Devos P. et al. Gamma Knife radiosurgery of brainstem cavernous malformations. Stereotact Funct Neurosurg 2016;94(6):397–403. DOI: 10.1159/000452844
13. Rahmathulla G., Marko N.F., Weil R.J. Cerebral radiation necrosis : a review of the pathobiology, diagnosis and management considerations. J Clin Neurosci 2013;20(4):485–502. DOI: 10.1016/j.jocn.2012.09.011
14. Vellayappan B., Tan C.L., Yong C. et al. Diagnosis and management of radiation necrosis in patients with brain metastases. Front Oncol 2018;8:395. DOI: 10.3389/fonc.2018.00395
15. Kim M.S., Pyo S.Y., JeongY.G. et al. Gamma knife surgery for intracranial cavernous hemangioma. J Neurosurg 2005;102(Suppl):102–6. DOI: 10.3171/jns.2005.102.s_supplement.0102
Review
For citations:
Girya E.N., Evdokimova O.L., Kochakova A.A., Tokarev A.S., Sinitsyn V.E. Radiation-induced complication of stereotactic radiosurgical treatment of cavernous malformation of the brain. Russian journal of neurosurgery. 2024;26(4):88-93. (In Russ.) https://doi.org/10.17650/1683-3295-2024-26-4-88-93
Views:
177
Email this article 