title: De novo development of a cerebral arteriovenous malformation following radiation therapy: Case report and an update to classical arteriovenous malformation nomenclature.
abstract: Cerebral arteriovenous malformations (AVM) are traditionally considered primary congenital lesions that result from embryological aberrations in vasculogenesis. Recent insights, however, suggest that these lesions may be secondary to a vascular insult such as ischemia or trauma. Herein, the authors present a rare case of a secondary cerebral AVM, occurring in a young girl who received prior cranial radiation therapy. At age 3years, she underwent surgical resection, chemotherapy, and photon radiation therapy for treatment of a fourth ventricular ependymoma. At age 19years, she developed new onset seizures and was found to have a left medial temporal lobe AVM. Her seizures were managed successfully with anti-epileptic medications and the AVM was treated with proton radiation therapy. This case highlights a rare but possible vascular sequela of radiation therapy and adds to the growing body of evidence that cerebral AVM may arise as secondary lesions.
authors: Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, White 502, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: mjkoch@MGH.Harvard.edu.
authors: Matthew J
authors: MJ
authors: Koch
authors: Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, White 502, 55 Fruit Street, Boston, MA 02114, USA.
authors: Pankaj K
authors: PK
authors: Agarwalla
authors: Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, White 502, 55 Fruit Street, Boston, MA 02114, USA.
authors: Christopher J
authors: CJ
authors: Stapleton
authors: Department of Surgery, Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors: Christopher S
authors: CS
authors: Ogilvy
authors: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors: Jay S
authors: JS
authors: Loeffler
mesh_terms: D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D007223:Infant; D002538:Intracranial Arteriovenous Malformations / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects*; D009626:Terminology as Topic
keywords: Arteriovenous malformation; Radiation therapy; Vascular malformation