Brain edema due to venous thrombosis following stereotactic radiosurgery for a cerebral arteriovenous malformation (AVM) has rarely been reported. We report a patient with a large AVM in the eloquent area, and brain edema developed in this area after repeat Gamma knife stereotactic radiosurgery (GKRS). An 18-year-old female presented with a 4-year-history of persistent headache. Magnetic resonance imaging and transfemoral carotid angiogram revealed a high-flow large AVM in the left parieto-occipital area. Brain edema developed and aggravated patient's symptoms after time-staged GKRS. The cause of edema was thought to be the failure of the surrounding venous channels to drain the venous flow from the normal brain and the drainage was hampered by the persistent shunt flow from the AVM, which was due to the thrombosis of one huge draining vein of the AVM. The microsurgical resection of the AVM nidus eliminated shunt flow and completely normalized the brain edema. Microsurgical resection of the AVM nidus completely normalized the brain edema due to thrombosis of a draining vein of an AVM develops after SRS.

中文翻译：

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重复伽玛刀放射外科治疗大动静脉畸形后脑水肿：一例报告。

立体定向放射外科手术治疗脑动静脉畸形（AVM）后由于静脉血栓形成引起的脑水肿的报道很少。我们报道了一名患者在雄辩区域出现大型AVM，并且在重复进行伽玛刀立体定向放射外科手术（GKRS）后，该区域出现了脑水肿。一名18岁女性表现出持续性头痛的4年病史。磁共振成像和经股动脉颈血管造影显示左顶枕区有高流量大AVM​​。分阶段进行GKRS后，脑水肿发展并加重了患者的症状。水肿的原因被认为是周围静脉通道无法引流正常大脑的静脉血流，并且引流受到AVM持续的分流的阻碍，这是由于AVM的一条巨大引流静脉血栓形成所致。AVM nidus的显微手术切除消除了分流并完全恢复了脑水肿。由于SRS后出现AVM引流静脉血栓形成，因此AVM nidus的显微手术切除术完全使脑水肿正常化。