Statham P, Macpherson P, Johnston R, Forster D M, Adams J H, Todd N V
Department of Neurosurgery, Southern General Hospital, Glasgow, United Kingdom.
J Neurol Neurosurg Psychiatry. 1990 Jun;53(6):476-9. doi: 10.1136/jnnp.53.6.476.
A patient presented with symptoms and signs of raised intracranial pressure and increasing focal deficit 13 months after stereotactic radiosurgical treatment of an arteriovenous malformation (AVM). Computed Tomography (CT) showed a mass lesion at the site of the previous abnormality typical of radiation necrosis, but with features identical to those of a malignant neoplasm. Biopsy confirmed cerebral radiation necrosis. The radiation dose was 25 Gray to the periphery of two overlapping 14 mm collimator fields, delivered in a single dose. Treatment with steroids led to improvement in the symptoms and signs of raised intracranial pressure, but not the focal deficit. Radiation necrosis is a consequence of the large doses required to obliterate AVMs and is a limiting factor in their treatment. It is important for clinicians referring patients for stereotactic radiosurgery to be aware of this complication, and to be able to recognise and treat it.
一名患者在接受立体定向放射外科治疗动静脉畸形（AVM）13个月后，出现颅内压升高和局灶性神经功能缺损加重的症状和体征。计算机断层扫描（CT）显示在先前异常部位有一个肿块病变，典型的放射性坏死，但具有与恶性肿瘤相同的特征。活检证实为脑放射性坏死。放射剂量为两个重叠的14毫米准直器野周边25格雷，单次给予。使用类固醇治疗使颅内压升高的症状和体征有所改善，但局灶性神经功能缺损未改善。放射性坏死是消除AVM所需大剂量放射的结果，是其治疗中的一个限制因素。对于将患者转诊接受立体定向放射外科治疗的临床医生来说，了解这种并发症并能够识别和治疗它很重要。
