Abstract:
OBJECTIVE:Hyperbaric oxygenation is a rarely used method of treatment for steroid-refractory radiation-induced edema after stereotactic radiosurgery. We present its successful implementation for a radiosurgical complication after the treatment of a deep, large arteriovenous malformation. We also review the literature on hyperbaric oxygenation for radiation-induced complications. CLINICAL PRESENTATION:A 25-year-old man underwent radiosurgical treatment for a large arteriovenous malformation. Three years later, substantially smaller remaining nidus was retreated. Five months after that treatment, the patient developed edema around the nidus and hemiparesis. This problem was refractory to high-dose steroids. INTERVENTION:The patient underwent a course of 25 hyperbaric oxygenation treatments. Within 1 month, the edema and hemiparesis had improved, allowing steroids to be tapered. A follow-up examination 1 year later revealed complete thrombosis of the arteriovenous malformation and minimal neurological deficit. CONCLUSION:This technical case report adds to the few studies in the literature suggesting that hyperbaric oxygenation therapy, in conjunction with a slow steroid taper, is a reasonable addition to the treatment armamentarium for radiation-induced cerebral edema associated with clinically evident neurological deficits.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Lynn M,Friedman WAdoi
10.1227/01.NEU.0000255343.41206.6Fsubject
Has Abstractpub_date
2007-03-01 00:00:00pages
E579; discussion E579issue
3eissn
0148-396Xissn
1524-4040pii
00006123-200703000-00024journal_volume
60pub_type
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