Acute Onset of Hemiparesis After Gamma Knife Radiosurgery for Arteriovenous Malformation Caused by Hyperacute Thrombosis of Draining Vein: A Case Report

A. S. Ramesh; Arivazhagan Arimappamagan; Dhananjaya Bhat; H. R. Arvinda; Sampath Somanna

doi:10.1055/s-0033-1349334

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e261-e265
DOI: 10.1055/s-0033-1349334

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Acute Onset of Hemiparesis After Gamma Knife Radiosurgery for Arteriovenous Malformation Caused by Hyperacute Thrombosis of Draining Vein: A Case Report

A. S. Ramesh

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India

,

Arivazhagan Arimappamagan

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India

,

Dhananjaya Bhat

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India

,

H. R. Arvinda

²Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India

,

Sampath Somanna

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India

› Author Affiliations

Abstract

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.

Keywords

arteriovenous malformation - GKRS - gamma knife radiosurgery - radiosurgery - early complication - draining vein thrombosis - occlusive hyperemia

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References

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