title: [Symptomatic radiation necrosis 10 years after gamma knife surgery for arteriovenous malformations: a case report].
abstract: We present a case of symptomatic radiation necrosis after gamma knife surgery for arteriovenous malformations (AVMs). Initially, at the age of 30 years the patient was treated with gamma knife surgery. Angiography performed 2 years after radiation therapy revealed that the AVMs were completely obliterated. Five years later, the patient had a generalized convulsion and a computed tomography (CT) scan showed a cystic formation in the irradiated area. The patient was treated with a cyst-peritoneal (CP) shunt. Thereafter, the patient seemed to be cured, but 5 years after CP shunt treatment, the patient had right hemiparesis, agraphia, and right hemianopsia. Magnetic resonance imaging (MRI) revealed radiation necrosis in the left parietooccipital region and midline shift of the brain. The patient was operated on and the hyalinized nidus and CP shunt tube were removed. The patient fully recovered from the symptoms and resumed work.
authors.affiliation: Department of Neurosurgery, Nara Medical University, 840 Shijo-cho, Kashiharashi, Nara 634-8521, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Nishimura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Motoyama
authors.forename: Junichi
authors.initials: J
authors.lastname: Ihida
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakase
authors.forename: Toshisuke
authors.initials: T
authors.lastname: Sakaki
authors.forename: Shigenori
authors.initials: S
authors.lastname: Minami
authors.forename: Toshihide
authors.initials: T
authors.lastname: Tsuzuki
mesh_terms: D000328:Adult; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D008297:Male; D009336:Necrosis; D009778:Occipital Lobe / Q000473:pathology* / Q000601:surgery; D010296:Parietal Lobe / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications; D016634:Radiosurgery / Q000009:adverse effects*; D016896:Treatment Outcome