Hyperbaric oxygen in the treatment of a radiosurgical complication: technical case report.

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

Neurosurgery

journal_title

Neurosurgery

authors

Lynn M,Friedman WA

doi

10.1227/01.NEU.0000255343.41206.6F

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

E579; discussion E579

issue

3

eissn

0148-396X

issn

1524-4040

pii

00006123-200703000-00024

journal_volume

60

pub_type

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