Journal of Cerebrovascular and Endovascular Neurosurgery  2015;17(1):36-42

doi:10.7461/jcen.2015.17.1.36

Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause.

Dong Han KIM 1 ; Dong Hun KANG ; Jaechan PARK ; Jeong Hyun HWANG ; Seong Hyun PARK ; Won Soo SON

Affiliations

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Keywords

Arteriovenous malformation; Cerebral infarction; Gamma-knife radiosurgery; Radiation-induced vasculopathy

Country

Republic of Korea

Language

English

Abstract

Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were included in the radiation field and delayed injury to these is suggested to be the mechanism of the ischemic event.