Hyperbaric oxygen therapy for treatment of adverse radiation effects after stereotactic radiosurgery of arteriovenous malformations: case report and review of literature.
BACKGROUND
Adverse radiation effects are a known complication after the use of SRS for AVMs, although it is difficult to predict which patients will manifest with these side effects. Treatment of swelling due to ARE is usually medical, but refractory cases may require surgical decompression.


METHODS
This report presents a case of a patient who experienced AREs after SRS (edema, headaches, and nausea) that failed to respond to steroid treatment but was successfully treated with HBO. The treatment characteristics of this and of 5 other cases of radiation injury after SRS for AVM managed with HBO therapy are reviewed, and the pathophysiology is discussed.


CONCLUSIONS
Hyperbaric oxygen therapy provides a therapeutic option to treat AREs following SRS of cerebral AVMs.
Wanebo
John E
JE
Department of Neurosciences, Naval Medical Center San Diego, San Diego, CA, USA. wanebojs@aol.com
Kidd
Grant A
GA
King
Michael C
MC
Chung
Thomas S
TS
D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D001929:Brain Edema / Q000209:etiology; D006801:Humans; D006931:Hyperbaric Oxygenation; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery*; D007427:Intracranial Pressure; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009325:Nausea / Q000209:etiology; D009336:Necrosis / Q000209:etiology; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D016634:Radiosurgery / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology