Symptomatic thrombosed venous aneurysm after stereotactic radiosurgery for brain arteriovenous malformation: Case report of a late complication mimicking radiation necrosis

Neurocirugia (English Edition) Pub Date : 2025-09-01 DOI:10.1016/j.neucie.2025.500669

Gino A. Mendoza-Vega , Jason Riveros-Ruiz , Juan E. Basilio-Flores

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Abstract

Late complications of radiosurgery for brain arteriovenous malformation include cystic formation, chronic encapsulated hematoma and radiation-induced tumors. Other complications are rarely reported.

We present a case of an adult patient who received radiosurgery for treatment of an unruptured parietal arteriovenous malformation. He was followed-up for 10 years and angiographic cure was documented. Fifteen-years after radiosurgery, he complained of new-onset progressive focal seizures associated with a thrombosed venous aneurysm with persistent arteriovenous shunt angiographically occult but evidenced intraoperatively. After resection of the lesion, symptoms disappeared.

This case depicts a symptomatic thrombosed venous aneurysm presenting as a rare delayed complication of radiosurgery for the treatment of brain arteriovenous malformation, which can be associated with angiographically-occult persistent arteriovenous shunt.

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立体定向放射治疗脑动静脉畸形后的症状性血栓性静脉动脉瘤：一例模拟放射坏死的晚期并发症。

脑动静脉畸形放射治疗的晚期并发症包括囊性形成、慢性囊性血肿和放射性肿瘤。其他并发症很少报道。我们提出一个病例的成人病人接受放射手术治疗未破裂的顶骨动静脉畸形。随访10年，血管造影治疗记录在案。放射手术后15年，他主诉新发进行性局灶性癫痫与血栓形成的静脉动脉瘤有关，并伴有持续的动静脉分流，血管造影上隐匿，但术中证实。病变切除后症状消失。这个病例描述了一个有症状的血栓性静脉动脉瘤，作为治疗脑动静脉畸形的放射手术中一种罕见的延迟并发症，它可能与血管造影隐匿的持续性动静脉分流有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Neurocirugia (English Edition)

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