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[一例立体定向放射治疗后伴新生血管形成的脑动静脉畸形反复巢内出血病例]

[A case of cerebral arteriovenous malformation revealing repeated intranidal hemorrhage accompanying neovascularization after stereotactic radiosurgery].

作者信息

Awano Takayuki, Kano Toshikazu, Nagaoka Takafumi, Kimura Shigeyoshi, Kano Tsuneo, Kido Goro, Katayama Yoichi, Kotani Akio

机构信息

Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.

出版信息

No Shinkei Geka. 2006 Sep;34(9):927-32.

Abstract

We report a patient with cerebral arteriovenous malformation (AVM) revealing growing mass lesion after stereotactic radiosurgery. This 12-year-old female presented headache. CT scan showed hematoma at the head of the right caudate nucleus and angiography showed AVM at the site. LINAC-based stereotactic radiosurgery was performed with the patient. Twenty-three months after the radiosurgery the patient complained headache and CT scan showed hematoma again at the same site, although angiography did not show AVM. Thirty-five months after the radiosurgery mass lesion with enhancement effect was observed at the site and the mass lesion grew gradually thereafter. Thirty-nine months after the radiosurgery the mass lesion was evacuated. Histological examination revealed fibrotic core and surrounding neovascularized area with hemorrhage. The histology shows a new etiology of growing mass lesion after radiosurgery for AVM.

摘要

我们报告了一例患有脑动静脉畸形(AVM)的患者,该患者在立体定向放射治疗后出现了不断增大的肿块病变。这名12岁女性出现头痛症状。CT扫描显示右侧尾状核头部有血肿,血管造影显示该部位存在AVM。对该患者进行了基于直线加速器的立体定向放射治疗。放射治疗23个月后,患者再次抱怨头痛,CT扫描显示同一部位再次出现血肿,尽管血管造影未显示AVM。放射治疗35个月后,在该部位观察到有强化效应的肿块病变,此后肿块病变逐渐增大。放射治疗39个月后,对肿块病变进行了切除。组织学检查显示有纤维化核心以及周围伴有出血的新生血管化区域。组织学表现揭示了AVM立体定向放射治疗后肿块病变增大的一种新病因。

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