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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Left Thalamus Arteriovenous Malformation Secondary to Radiation Therapy of Original Vermian Arteriovenous Malformation: Case Report
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Left Thalamus Arteriovenous Malformation Secondary to Radiation Therapy of Original Vermian Arteriovenous Malformation: Case Report

机译：左丘脑动静脉畸形继发于原始佛像畸形的放射治疗：案例报告

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摘要

A 70-year-old gentleman with history of hypothyroidism, hyperlipidemia, hypertension, and right superior cerebellar aneurysm presented to the neurosurgery service in 2008 with vertigo. Diagnostic cerebral angiography performed that year demonstrated a vermian arteriovenous malformations (AVM). The patient underwent stereotactic proton beam radiosurgery, which resulted in a decrease in flow and size of the lesion, and the patient was lost to follow-up. Now at the age of 80, the patient presented with acute gait instability. Cerebral angiogram demonstrated his stable vermian AVM and a new 1.1 cm AVM nidus in the region of the left posterior thalamus. Although AVMs are often described as congenital lesions, there is a growing body of literature suggesting that AVMs can grow, spontaneously regress, and even arise de novo in response to some insult. Understanding what leads to the growth, remodeling, regression, and hemorrhage of AVMs is crucial in order to better direct therapeutic endeavors. We would argue that this patient's AVM is secondary to endothelial cell damage from radiation therapy. Radiation can cause endothelial cell injury and upregulation of factors, such as vascular endothelial growth factor and transforming growth factor beta expression, which are implicated in AVM development pathways. We believe that this patient's new AVM is secondary to entrance radiation dosing affecting the thalamus during radiation therapy for the original vermian AVM.
机译：一个70岁的绅士，患有甲状腺功能亢进，高脂血症，高血压和右高级小脑动脉瘤的历史，2008年呈现给神经外科服务的眩晕服务。诊断脑血管造影表明，该年表现出粉剂动静脉畸形（AVM）。患者接受了立体定向质子束放射牢，这导致病变的流动和尺寸减少，并且患者失去了随访。现在在80岁时，患者呈现出急性步态不稳定。脑血管造影展示了他稳定的佛航AVM和左后丘脑区域区域的新1.1cm AVM纳米。虽然AVM往往被描述为先天性病变，但是有一种不断增长的文献体系，表明AVM可以增长，自发地回归，甚至是为了应对一些侮辱而产生的De Novo。理解AVM的增长，重塑，回归和出血的导致什么是至关重要的，以便更好地直接治疗努力。我们认为该患者的AVM是来自放射治疗的内皮细胞损伤。辐射可引起内皮细胞损伤和血管内皮生长因子等因素的上调，以及转化生长因子β表达，其涉及AVM发育途径。我们认为，该患者的新AVM是在原始佛航AVM的放射治疗期间影响丘脑的入射辐射给药。

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