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Cyst Formation Following Radiosurgery for AVMs: Report of 3 Cases

Published online by Cambridge University Press:  18 February 2016

Q. Al Hinai ,
D. Tampieri ,
L. Souhami ,
A. Sadikot ,
D. Sinclair  and
R. Leblanc
Q. Al Hinai
Affiliation:
Department of Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
D. Tampieri
Affiliation:
Department of Diagnostic and Interventional Neuroradiology, McGill University Health Centre, Montreal, Quebec, Canada
L. Souhami
Affiliation:
Montreal Neurological Hospital & Institut, Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada
A. Sadikot
Affiliation:
Department of Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
D. Sinclair
Affiliation:
Department of Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
R. Leblanc*
Affiliation:
Department of Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
*
Department of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, 3801 University Street, Montreal, Quebec, H3A 2B4, Canada
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Abstract:

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Background:

Stereotactically-focused radiosurgery (SRS) for the treatment of arteriovenous malformations (AVM) has been in widespread use for over two decades. Over this timeframe the indications for treatment, standardization of radiation dosage, and the results expected from treatment have been elaborated. Less well known are the long-term complications associated with SRS. We report three patients who had SRS for the treatment of AVM who developed a cyst at the site of treatment as a late complication.

Methods:

From 201 patients treated by SRS for an AVM, three developed a cyst at the treatment site. Their clinical presentation, the characteristics of the AVMs and the treatment were reviewed, as well as similar cases gleaned from the literature.

Results:

Three women, aged 28-43 years, had an AVM treated by: craniotomy and clipping of arterial feeders followed by SRS, by craniotomy for resection followed by SRS or by endo vascular embolization and SRS. The patients did well following treatment but two of them developed a symptomatic and the other an asymptomatic cyst at the treatment site 3-19 years later. The symptomatic patients underwent marsupialization of the cyst and the other is under observation.

Conclusion:

Stereotactic radiosurgery is an established and safe treatment for patients with AVMs. Delayed cyst formation can occur many years after treatment and long term follow-up is indicated in patients whose AVM has been treated with SRS.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 5 , September 2011 , pp. 734 - 740
Copyright
Copyright © Canadian Neurological Sciences Federation 2011

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