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Radiation-Induced Cavernous Hemangiomas: Case Report and Literature Review

Published online by Cambridge University Press:  02 December 2014

Mark Robert Keezer  and
Rolando Del Maestro
Mark Robert Keezer
Affiliation:
Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
Rolando Del Maestro*
Affiliation:
Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
*
Brain Tumour Research Centre, Department of Neurosurgery, Montreal Neurological Institute and Hospital, 3801 University Street, BT 210, Montreal, Quebec, H3A 2B4, Canada
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Abstract

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The case of a 51-year-old man diagnosed with two acquired cavernous hemangiomas 17 years after cranial irradiation for a cerebellar astrocytoma is reported. A review of 84 cases of radiation-induced cavernous hemangiomas found in the literature is presented. In this series the mean age at the time of irradiation (±SD) was 10.4 ± 2.0 years (median = 8 years), while the mean time to cavernous hemangioma diagnosis (±SD) was 10.3 ± 1.9 years (median = 8 years). Time to cavernous hemangioma diagnosis was found to be inversely related to radiation dose. Hemorrhage from radiation-induced cavernous hemangiomas was found in 40.0% of patients, with an incidence of 3.9% per patient year. An inverse trend was identified between radiation dose and symptomatic presentation, cavernous hemangioma hemorrhage or surgical resection. This review of radiation-induced cavernous hemangiomas confirms that both younger patients and those who received a larger dose of radiation are at increased risk of radiation-induced cavernous hemangiomas. Our results suggest that, based on an assessment of CT or MR images, there may be an increased risk of hemorrhage when comparing radiation-induced to congenital cavernous hemangiomas. Increasing radiation doses appear to stabilize these lesions, decreasing the risk of a symptomatic presentation, cavernous hemangioma hemorrhage and surgical intervention.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 3 , May 2009 , pp. 303 - 310
Copyright
Copyright © The Canadian Journal of Neurological 2009

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