Surgical removal of radio-induced lesions after radiosurgery of cerebral arteriovenous malformations

Radioinduced lesions after radiosurgery of cerebral arteriovenous malformat ions may be associated with an increased signal on T2-weighted and gadolini um enhancement on T1-weighted MR images. They do not have necessarily a poo r, prognosis. These lesions are mostly asymptomatic. But in a few cases the y can be associated with severe clinical symptoms which can become corticod ependant or corticoresistant. We present the 5 cases of such cerebral arteriovenous malformations treated by radiosurgery, out of our series of 705 patients The removal was easier than that of untreated cerebral arteriovenous malformations, and led to a c omplete recovery of symptoms and progressive decrease of imaging abnormalit ies. Such surgery should be proposed in case of symptomatic radioinduced lesions which fail to respond to steroids.