title: Acute onset of hemiparesis after gamma knife radiosurgery for arteriovenous malformation caused by hyperacute thrombosis of draining vein: a case report.
abstract: BACKGROUND
  Complications after gamma knife radiosurgery (GKRS) have been attributed most commonly to radiation-induced damage to the brain. Early occlusion of the draining veins has been postulated as one of the rare causes of complications after GKRS, which often occurs at or beyond 6 months after GKRS.
  
  
  METHODS
  We present a very rare incidence of acute onset of hemiparesis caused by a draining vein occlusion within 24 hours after GKRS for arteriovenous malformation. The patient developed hemiparesis within one day after GKRS, which partially improved with steroids. Radiologic investigations revealed an early occlusion of a draining vein, resulting in occlusive hyperemia and neurologic deficit.
  
  
  CONCLUSIONS
  Early draining vein occlusion is an important cause of postradiosurgery complications, and it can rarely occur within days.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
authors.forename: A S
authors.initials: AS
authors.lastname: Ramesh
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
authors.forename: Arivazhagan
authors.initials: A
authors.lastname: Arimappamagan
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
authors.forename: Dhananjaya
authors.initials: D
authors.lastname: Bhat
authors.affiliation: Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
authors.forename: H R
authors.initials: HR
authors.lastname: Arvinda
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
authors.forename: Sampath
authors.initials: S
authors.lastname: Somanna
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D004322:Drainage; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000209:etiology; D020767:Intracranial Thrombosis / Q000209:etiology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D010291:Paresis / Q000209:etiology*; D011183:Postoperative Complications / Q000628:therapy*; D016634:Radiosurgery / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed