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Journal of Korean Neurosurgical Society 2003;33(1): 76-80.
A Case of Recurrent Expansile Cyst Formation after Gamma Knife Radiosurgery for a Cerebral Arteriovenous Malformation: Role of the Residual Nidus: Case Report.
Won Kil Bok, Kyung Soo Min, Mou Seop Lee, Yang Kwon
1Department of Neurosurgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
2Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
The authors report a case of recurrent expansile cyst formation after gamma knife radiosurgery(GKRS) for a cerebral arteriovenous malformation where the residual nidus might play an important role. A 28-year-old male patient underwent gamma knife radiosurgery for a left parietal lobe arteriovenous malformation which had manifested with generalized tonic-clonic seizure in November 1992. In March 1999, 76 months after GKRS, the patient presented with headache, dysphasia and right hemiparesis and the computed tomography(CT) and magnetic resonance(MR) image revealed a huge cystic lesion with enhancing nodule at the anterior wall of the cyst. Cerebral angiography showed a small residual nidus. Aspiration and drainage of the cystic fluid via a burr hole was performed and the symptoms improved. One year later, in March 2000, the symptoms recurred, and CT and MR image revealed a new huge cystic lesion anterior to the enhancing nodule. Surgical removal of the residual nidus was performed, and there is no recurrence of the cyst for two years till now.
Key Words: Areteriovenous malformation; Gamma knife radiosurgery; Cyst; Residual nidus
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