Mohammed Nasser, Bunevicius Adomas, Muttikkal Thomas Eluvathingal, Druzgal Jason, P Sheehan Jason
University of Virginia, Department of Neurological Surgery, Charlottesville, VA, USA.
University of Virginia, Department of Radiology, Charlottesville, VA, USA.
J Radiosurg SBRT. 2020;7(2):169-172.
Superficial siderosis (SS) of the brain results from a chronic iron toxicity due to repeated microscopic leakage of blood products into the subarachnoid space. We report on Gamma Knife Radiosurgery (GKRS) associated worsening of superficial siderosis in a patient with skull-base tumor. A 73 year-old male patient presented with clumsiness and gait ataxia and was diagnosed with foramen magnum meningioma. He was also noted to have superficial siderosis involving the mainly the infratentorial compartment. After a thorough evaluation of craniospinal axis, no other cause of bleeding was identified. Patient was treated with the GKRS. After GKRS, there was an initial radiological and clinical worsening of SS starting at 6 months and peaking at 2 years. The disease stabilized and showed mild reduction at 3 years. GKRS lead to an initial progression of superficial siderosis. However, over a longer period, tumor control and improvement of the siderosis was observed.
脑表面铁沉积症（SS）是由于血液产物反复微量渗漏至蛛网膜下腔导致的慢性铁中毒所致。我们报告了1例颅底肿瘤患者在接受伽玛刀放射外科治疗（GKRS）后，脑表面铁沉积症病情恶化的情况。1名73岁男性患者因肢体笨拙和步态共济失调就诊，被诊断为枕骨大孔脑膜瘤。还发现其脑表面铁沉积症主要累及幕下腔。对其颅脊髓轴进行全面评估后，未发现其他出血原因。该患者接受了GKRS治疗。GKRS治疗后，SS在6个月时开始出现影像学和临床症状的初始恶化，并在2年时达到高峰。病情在3年时稳定下来，并略有缓解。GKRS导致脑表面铁沉积症初期进展。然而，在较长一段时间后，观察到肿瘤得到控制，铁沉积症有所改善。
