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

Mendoza-Vega G.A.; Riveros-Ruiz J.; Basilio-Flores J.E. · Neurocirugia (2025) · DOI: 10.1016/j.neucir.2025.500669

Resumen

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.

Instituciones: Universidad Nacional Mayor de San Marcos