MRI-Guided Laser Interstitial Thermal Therapy for Radiation Necrosis in Previously Irradiated Brain Arteriovenous Malformations

Abstract

Radiation necrosis (RN) is a well-described complication after radiosurgery (SRS) for intracranial pathologies. It has been reported most frequently after SRS for brain metastases but has also been reported in up to 33% of patients with SRS-treated brain arteriovenous malformations (AVM).1 Treatment with chronic steroids has remained first-line therapy for several reasons: (1) many cases of RN can resolve spontaneously over time; and (2) most cases were treated initially with SRS owing to concerns for surgical morbidity of AVM resection, and in some cases, residual live AVM may coexist with RN.