伽玛刀放射外科治疗动静脉畸形后因引流静脉超急性血栓形成导致偏瘫急性发作：一例报告
Acute onset of hemiparesis after gamma knife radiosurgery for arteriovenous malformation caused by hyperacute thrombosis of draining vein: a case report.
作者信息
Ramesh A S, Arimappamagan Arivazhagan, Bhat Dhananjaya, Arvinda H R, Somanna Sampath
机构信息
Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
出版信息
J Neurol Surg A Cent Eur Neurosurg. 2013 Dec;74 Suppl 1:e261-5. doi: 10.1055/s-0033-1349334. Epub 2013 Aug 1.
BACKGROUND
Complications after gamma knife radiosurgery (GKRS) have been attributed most commonly to radiation-induced damage to the brain. Early occlusion of the draining veins has been postulated as one of the rare causes of complications after GKRS, which often occurs at or beyond 6 months after GKRS.
CLINICAL PRESENTATION
We present a very rare incidence of acute onset of hemiparesis caused by a draining vein occlusion within 24 hours after GKRS for arteriovenous malformation. The patient developed hemiparesis within one day after GKRS, which partially improved with steroids. Radiologic investigations revealed an early occlusion of a draining vein, resulting in occlusive hyperemia and neurologic deficit.
CONCLUSION
Early draining vein occlusion is an important cause of postradiosurgery complications, and it can rarely occur within days.
背景
伽玛刀放射外科手术（GKRS）后的并发症最常见于辐射引起的脑损伤。引流静脉早期闭塞被认为是GKRS后罕见的并发症原因之一，通常发生在GKRS后6个月或更晚。
临床表现
我们报告了1例非常罕见的病例，在因动静脉畸形接受GKRS后24小时内，由引流静脉闭塞导致急性偏瘫发作。患者在GKRS后一天内出现偏瘫，使用类固醇后部分改善。影像学检查显示引流静脉早期闭塞，导致闭塞性充血和神经功能缺损。
结论
引流静脉早期闭塞是放射外科手术后并发症的重要原因，且很少在数天内发生。
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