Abstract
This case report presents a patient suffering acute fatal intracranial-intratumoral hemorrhage during a gamma knife treatment session. Acute hemorrhage during a radiosurgery session is extremely rare and a plausible cause for this case is discussed along with a literature review of previously reported incidents. The patient was a 71-year-old male presenting with three large intracranial lesions and an underlying primary renal cell carcinoma malignancy. Because of a severe kyphotic deformity resulting from ankylosing spondylitis, the patient was placed in a moderate Trendelenburg position to allow his head to fit into the gamma knife unit during the radiosurgery session. The two left-sided lesions were to be treated with 20 Gy to the 50% isodose line, and the right-sided lesion with 16 Gy to the 40% isodose line. Anesthesia was available throughout the treatment session to aid with pain control. The gamma knife treatment was aborted because the patient suffered a generalized seizure while in the unit. Immediate head CT of the patient revealed large acute hemorrhages into all three intracranial masses. This proved to be a fatal complication. It is likely that this positioning contributed to the hemorrhage. The clinical history of this patient is provided as well as a review of the literature on acute intracranial hemorrhage associated with radiosurgical therapy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 838-842 |
| Number of pages | 5 |
| Journal | Clinical Neurology and Neurosurgery |
| Volume | 110 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2008 |
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Keywords
- Ankylosing spondylitis
- Gamma knife
- Intratumoral hemorrhage
- Radiosurgery complication
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Neurology
Cite this
Fatal case of intracerebral hemorrhage during gamma knife treatment for metastases. / Anderson, William S; Moore, Laurel E.; Ford, Eric; Rigamonti, Daniele.
In: Clinical Neurology and Neurosurgery, Vol. 110, No. 8, 08.2008, p. 838-842.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Fatal case of intracerebral hemorrhage during gamma knife treatment for metastases
AU - Anderson, William S
AU - Moore, Laurel E.
AU - Ford, Eric
AU - Rigamonti, Daniele
PY - 2008/8
Y1 - 2008/8
N2 - This case report presents a patient suffering acute fatal intracranial-intratumoral hemorrhage during a gamma knife treatment session. Acute hemorrhage during a radiosurgery session is extremely rare and a plausible cause for this case is discussed along with a literature review of previously reported incidents. The patient was a 71-year-old male presenting with three large intracranial lesions and an underlying primary renal cell carcinoma malignancy. Because of a severe kyphotic deformity resulting from ankylosing spondylitis, the patient was placed in a moderate Trendelenburg position to allow his head to fit into the gamma knife unit during the radiosurgery session. The two left-sided lesions were to be treated with 20 Gy to the 50% isodose line, and the right-sided lesion with 16 Gy to the 40% isodose line. Anesthesia was available throughout the treatment session to aid with pain control. The gamma knife treatment was aborted because the patient suffered a generalized seizure while in the unit. Immediate head CT of the patient revealed large acute hemorrhages into all three intracranial masses. This proved to be a fatal complication. It is likely that this positioning contributed to the hemorrhage. The clinical history of this patient is provided as well as a review of the literature on acute intracranial hemorrhage associated with radiosurgical therapy.
AB - This case report presents a patient suffering acute fatal intracranial-intratumoral hemorrhage during a gamma knife treatment session. Acute hemorrhage during a radiosurgery session is extremely rare and a plausible cause for this case is discussed along with a literature review of previously reported incidents. The patient was a 71-year-old male presenting with three large intracranial lesions and an underlying primary renal cell carcinoma malignancy. Because of a severe kyphotic deformity resulting from ankylosing spondylitis, the patient was placed in a moderate Trendelenburg position to allow his head to fit into the gamma knife unit during the radiosurgery session. The two left-sided lesions were to be treated with 20 Gy to the 50% isodose line, and the right-sided lesion with 16 Gy to the 40% isodose line. Anesthesia was available throughout the treatment session to aid with pain control. The gamma knife treatment was aborted because the patient suffered a generalized seizure while in the unit. Immediate head CT of the patient revealed large acute hemorrhages into all three intracranial masses. This proved to be a fatal complication. It is likely that this positioning contributed to the hemorrhage. The clinical history of this patient is provided as well as a review of the literature on acute intracranial hemorrhage associated with radiosurgical therapy.
KW - Ankylosing spondylitis
KW - Gamma knife
KW - Intratumoral hemorrhage
KW - Radiosurgery complication
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UR - http://www.scopus.com/inward/citedby.url?scp=49949085715&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2008.05.012
DO - 10.1016/j.clineuro.2008.05.012
M3 - Article
C2 - 18586383
AN - SCOPUS:49949085715
VL - 110
SP - 838
EP - 842
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
SN - 0303-8467
IS - 8
ER -