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
1   Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
,
Arivazhagan Arimappamagan
1   Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
,
Dhananjaya Bhat
1   Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
,
H. R. Arvinda
2   Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
,
Sampath Somanna
1   Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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Publikationsverlauf

14. Oktober 2012

22. März 2013

Publikationsdatum:
01. August 2013 (online)

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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.