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Neurological Surgery No Shinkei Geka Volume 34, Issue 9 （September 2006）

Neurological Surgery 脳神経外科 34巻9号（2006年9月発行）

Japanese English

症例

定位放射線手術後のnidus内に血管新生を伴って出血を繰り返した脳動静脈奇形の1例 A Case of Cerebral Arteriovenous Malformation Revealing Repeated Intranidal Hemorrhage Accompanying Neovascularization after Stereotactic Radiosurgery 粟野貴志 ¹ , 加納利和 ¹ , 永岡右章 ¹ , 木村重吉 ² , 加納恒男 ¹ , 木戸悟郎 ² , 片山容一 ¹ , 小谷昭夫 ² Takayuki AWANO ¹ , Toshikazu KANO ¹ , Takafumi NAGAOKA ¹ , Shigeyoshi KIMURA ² , Tsuneo KANO ¹ , Goro KIDO ² , Yoichi KATAYAMA ¹ , Akio KOTANI ² ¹日本大学医学部脳神経外科 ²春日部市立市民病院脳神経外科 ¹Department of Neurological Surgery,Nihon University School of Medicine ²Department of Neurosurgery,Kasukabe Municipal Hospital キーワード： arteriovenous malformation , stereotactic radiosurgery , growing mass lesion , neovascularization Keyword: arteriovenous malformation , stereotactic radiosurgery , growing mass lesion , neovascularization pp.927-932

発行日 2006年9月1日 Published Date 2006/9/1

DOI https://doi.org/10.11477/mf.1436100280

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Ⅰ．はじめに

　Stereotactic radiosurgery（SRS）後，出血を伴って増大する腫瘤が形成された AVM（arteriovenous malformation）症例について組織学的検討を行ったので報告する．

　We report a patient with cerebral arteriovenous malformation (AVM) revealing growing mass lesion after stereotactic radiosurgery. This 12-year-old female presented headache. CT scan showed hematoma at the head of the right caudate nucleus and angiography showed AVM at the site. LINAC-based stereotactic radiosurgery was performed with the patient. Twenty-three months after the radiosurgery the patient complained headache and CT scan showed hematoma again at the same site,although angiography did not show AVM. Thirty-five months after the radiosurgery mass lesion with enhancement effect was observed at the site and the mass lesion grew gradually thereafter. Thirty-nine months after the radiosurgery the mass lesion was evacuated. Histological examination revealed fibrotic core and surrounding neovascularized area with hemorrhage. The histology shows a new etiology of growing mass lesion after radiosurgery for AVM.