Late complications of radiosurgery for cerebral arteriovenous malformations: report of 5 cases of chronic encapsulated intracerebral hematomas and review of the literature.

Radiation Oncology
Stephanos FinitsisRené Anxionnat

Abstract

Chronic encapsulated intracerebral hematomas (CEIHs) are a rare, late complication of radiosurgery for intracranial AVM. We present 5 cases treated mostly by surgical excision and review the literature. Patients (age 39, 42, 36, 31, 62) presented with headache, paresthesia, hemiparesis or were asymptomatic. CEIHs presented 10 to 13 years (median 12 years) post radiosurgery. Three patients had demonstrated early radiation induced changes post radiosurgery. Angiographic cure, assessed with DSA, was present in all cases except 1 case with a small nidus remnant. MRI demonstrated mixed lesions with a solid enhancing part, organized hematoma and extensive surrounding edema while three cases had also a cystic component. Excision of the CEIHs with complete or partial removal of the capsule was performed in 4 patients and resulted in marked clinical improvement. One patient was managed conservatively with administration of steroids as surgery was judged excessively hazardous with eventual stabilization of his symptoms. CEIHs are rare, late complications of radiosurgery for cranial AVM. They may be asymptomatic or provoke symptoms and may be preceded by early radiation induced changes. Complete removal of CEIHS is an effective treatment....Continue Reading

References

Jul 10, 1999·Acta neurochirurgica·V Radanowicz-HarttmannO Gratzl
Apr 2, 2008·Journal of Neurosurgery. Pediatrics·David Hung-Chi PanTai-Tong Wong
Sep 25, 2008·Neurologia Medico-chirurgica·Hiroaki MotegiYoshinobu Iwasaki
Mar 22, 2014·Journal of Korean Neurosurgical Society·Satoru TakeuchiKentaro Mori
Aug 8, 2015·Journal of Neurosurgery·Xiaochuan HuoYouxiang Li
Jul 20, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Hideki NakajimaYoshiyasu Iwai

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Citations

Jun 29, 2021·Curēus·Elise J YoonRobert W Mccabe

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