De novo cavernous malformation after radiosurgery for cerebellar arteriovenous malformation: A case report
- Author:
Sang Heum Kim
;
Tae Gon Kim
;
Min Ho Kong
- Publication Type:Case report
- Keywords:
De novo cavernous malformation;
Radiation therapy;
Radiosurgery;
Arteriovenous malformation
- MeSH:
Radiosurgery
- From:Neurology Asia
2017;22(3):261-266
- CountryMalaysia
- Language:English
-
Abstract:
Stereotactic radiosurgery, including gamma knife radiosurgery (GKS), can in rare cases result in
de novo cavernous malformations (CMs). Here, we present a case of de novo CM induced by GKS
following treatment of a cerebellar arteriovenous malformation (AVM). A 48-year-old woman was
diagnosed with left unilateral Moyamoya disease. Conventional cerebral angiography also revealed an
AVM in the left cerebellum. The patient underwent GKS using a 50% isodose of 15 Gy at the margin
of the left cerebellar AVM. Magnetic resonance imaging (MRI) taken 3 years after GKS revealed
small chronic hemorrhages with perilesional edema in the left cerebellum. Five years later, the lesions
became aggravated, but were asymptomatic. Eight years following GKS, the patient was admitted
complaining of headache and dizziness. Brain MRI revealed a 1.3cm hemosiderin deposit with an
inner hyperintense nodular portion that was enhanced in the left cerebellum. An open craniotomy was
performed and the mass was removed, from which pathological findings were compatible with those
for CM. The patient recovered to the prehemorrhagic state. This case shows that De novo CMs can
rarely develop after radiosurgery. Most CMs have been reported to develop following radiosurgery
for brain tumors. As shown in this patient, CMs can also develop after radiosurgery for cerebellar
AVM in adults.
