Fatal case of intracerebral hemorrhage during gamma knife treatment for metastases

William S. Anderson, Laurel E. Moore, Eric Ford, Daniele Rigamonti

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)838-842
Number of pages5
JournalClinical Neurology and Neurosurgery
Volume110
Issue number8
DOIs
StatePublished - Aug 1 2008

Keywords

  • Ankylosing spondylitis
  • Gamma knife
  • Intratumoral hemorrhage
  • Radiosurgery complication

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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