Hara M, Nakamura M, Shiokawa Y, Sawa H, Sato E, Koyasu H, Saito I
Department of Neurosurgery, Kyorin University School of Medicine.
Minim Invasive Neurosurg. 1998 Mar;41(1):40-5. doi: 10.1055/s-2008-1052014.
Two patients who underwent gamma knife radiosurgery for ruptured cerebral arteriovenous malformations (AVM) developed cystic lesions at 78 and 111 months after undergoing treatment. Both patients presented initially with intracerebral hemorrhage. In one patient, the cystic lesion was discovered during routine follow-up imaging and clinical examination revealed homonymous hemianopsia; the second patient presented with seizure and the lesion was identified more than 9 years after radiosurgery. One patient underwent resection of the nidus and histologic analysis of the resected specimen showed vessels in various stages of obliteration. The present paper discusses the possible mechanism for the delayed development of cystic lesions, and the possibility that radiation-induced vascular changes may continue in a nidus even when angiography shows complete obliteration of the nidus.
两名接受伽玛刀放射外科治疗破裂脑动静脉畸形（AVM）的患者在治疗后78个月和111个月出现囊性病变。两名患者最初均表现为脑出血。其中一名患者在常规随访影像学检查时发现囊性病变，临床检查发现同向性偏盲；第二名患者出现癫痫发作，病变在放射外科治疗9年多后被发现。一名患者接受了病灶切除术，对切除标本的组织学分析显示血管处于不同的闭塞阶段。本文讨论了囊性病变延迟发生的可能机制，以及即使血管造影显示病灶完全闭塞，放射诱导的血管变化在病灶中仍可能持续的可能性。
