Usefulness of hyperbaric oxygen in the treatment of radionecrosis and symptomatic brain edema after LINAC radiosurgery

• Published in: Neurocirugía (Asturias, Spain) Vol. 20; no. 5; p. 449
• Main Authors: Pérez-Espejo, M A, García-Fernández, R, Tobarra-González, B M, Palma-Copete, J D, González-López, A, De la Fuente-Muñoz, I, Salinas-Ramos, J, Felipe-Murcia, M, Martínez-Lage, J F, Fernández-Pérez, J, Romero, J M
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-10-2009
• Subjects: Aged; Brain Damage, Chronic - etiology; Brain Damage, Chronic - prevention & control; Brain Edema - etiology; Brain Edema - pathology; Brain Edema - therapy; Brain Injuries - etiology; Brain Injuries - pathology; Brain Injuries - therapy; Cerebellar Neoplasms - surgery; Cerebellopontine Angle - pathology; Cerebellopontine Angle - radiation effects; Endothelium, Vascular - pathology; Endothelium, Vascular - radiation effects; Female; Humans; Hyperbaric Oxygenation; Magnetic Resonance Imaging; Meningeal Neoplasms - surgery; Meningioma - surgery; Middle Aged; Necrosis; Parietal Lobe - pathology; Parietal Lobe - radiation effects; Radiation Injuries - etiology; Radiation Injuries - pathology; Radiation Injuries - therapy; Radiosurgery - adverse effects; Treatment Outcome
• ISSN: 1130-1473

Radionecrosis with brain edema is a complication of radiosurgery. Three female patients harbouring a frontal pole, petrous and parasagital parietoocipital meningiomas respectively who had been treated with LINAC radiosurgery are presented. Those patients developed, between two and eight months later, a severe symptomatic radionecrosis with a huge brain edema resistant to the usual steroid therapy. Only after 40 sessions of hyperbaric oxygen, a good remission of the lesions was obtained. There are few cases reported in the literature with such a good outcome. Consequentely, this therapy must be taken into account to treat this type of radiosurgical complication before considering surgery.